Abstract P032: Perivascular Adipose Tissue and/or Epicardial Adiposity in Asymptomastic Obese Subjects is More Than a Scaffold: It is a Risk Marker for Cerebrovascular and Coronary Arttery Disease
Epicardial fat is inhomogeneous fat, different from the visceral fat and has a different messenger RNA. It has been recently implicated in the pathogenesis of the coronary artery disease (CAD) beyond the visceral fat. The purpose of this study was to examine whether excess Epicardial Fat Volume (EFV) in asymptomatic obese subjects is associated with Cerebrovascular and CAD as assessed by Early CVD Risk Score (ECVDRS) and Coronary Artery Calcium (CAC).
Method: We evaluated 2174 consecutive asymptomatic subjects (sbjs), age 23-80, who underwent screening for CVD risk using ECVDRS. ECVDRS consists of 10 non-invasive tests: large (C1) and small (C2) artery stiffness, blood pressure (BP) at rest and post mild exercise (BP PME), Carotid Intima Media Thickness (CIMT), abdominal aorta and left ventricular ultrasound, retinal photography, microalbuminuria, electrocardiogram, and pro-BNP. CAC and EFV were measured for a randomly selected group of sbjs, using Siemens Somatom Definition Dual source CT scanner.
Results: Among the sbjs. screened 44% (949 of 2174) were obese and 48% (462 of 949) had abnormal (abn) CIMT. Randomly selected 68 obese sbjs underwent additional screening for EFV and CAC revealing the results shown on the table 1.
EFV (Epicardial adiposity) is increased in obese subjects
Significant number of asymptomatic obese subjects with abn CIMT had significant CAC (p < 0.005).
3Early detection of subclinical atherosclerosis as documented by abn CIMT is a clue for the possible presence of coronary artery disease. Based on our study Epicardial adiposity is associated with significant cerebro and cardio vascular abnormalities. Accordingly we propose that all obese subjects should undergo screening for CIMT abnormalities and if clinically warranted to proceed with further CV evaluation for optimal risk stratification and management. Epicardial adiposity is a disease!
- © 2013 by American Heart Association, Inc.