Echocardiographic epicardial fat thickness is associated with arterial stiffness

Background: Epicardial adipose tissue represents visceral adiposity, the early detection of which could be helpful for assessing subclinical target organ damage. Although previous studies have reported a relationship between epicardial fat thickness (EFT) and carotid intima-media thickness, there have been no studies detailing the relationship between EFT and brachial-ankle pulse wave velocity (baPWV). Methods: We consecutively enrolled 655 subjects (445 men, 55 ± 9 years) who underwent echocardiography and baPWV and had an ankle-brachial index greater than 0.95. The subjects were divided into four quartile groups depending on EFT. Subjects were also classified into two groups according to baPWV: group I (324 subjects), baPWV ≤ 1366 cm/s, and group II (331 subjects), baPWV > 1366 cm/s. Results: The EFT in group II was significantly higher than in group I (4.2 mm vs. 3.7 mm, p < 0.001). There were significant differences in baPWV values among the EFT quartile groups (quartile I, 1327 ± 148.8 cm/s; quartile II, 1371 ± 215.0 cm/s; quartile III, 1434 ± 228.3 cm/s; quartile IV, 1507 ± 233.1 cm/s; p-value < 0.001). In multivariate regression models, the highest quartile groups of EFT had higher odds ratios (ORs) for increased baPWV compared with that of the lowest quartile group (OR [95% confidence interval (CI)]: 2.19[1.21-3.95]), irrespective of confounding factors. Moreover, EFT was an independent determinant of baPWV (standard β = 0.113, p = 0.001). Conclusions: This study demonstrates an independent relationship between EFT and arterial stiffness, suggesting that echocardiographic EFT measurement could be an easy-to-measure tool for early detection of subclinical target organ damage.