Epicardial adipose tissue and its association with cardiovascular risk factors and mitral annular calcium deposits

Abstract

Introduction Epicardial fat is a variety of visceral adipose tissue that secretes pro-inflammatory cytokines that can lead to progression of atherosclerosis. Previous studies have shown a correlation between cardiovascular risk factors and severity of mitral annular calcification. The aim of our study was to assess the correlation between epicardial fat thickness and mitral annular calcification. Methods This study recruited 188 patients who were considered for coronary angiography and underwent echocardiography within 24 hours of admission. Epicardial fat thickness was measured in the parasternal long axis view at the end-systole. Mitral annular calcification was visualized in the parasternal short-axis view and was grade as none, mild, moderate, and severe. Furthermore, left atrial diameter, severity of mitral regurgitation, left ventricular ejection fraction, and early diastolic velocities ( E wave) determined by transmitral pulsed Doppler, the early mitral annular velocities measured by tissue Doppler ( e′), and E/ e′ were obtained. Results Patients with an epicardial fat thickness ≥7 mm had higher prevalence of hypertension and higher SYNTAX score ( p value = 0.002 and 0.0014, respectively). Also, mitral annular calcification was both more prevalent and more extensive ( p value = 0.007 and <0.001, respectively) and left atrial diameter was larger in these patients compared with patients with epicardial fat thickness <7 mm ( p value = 0.001). Conclusions Our study showed significant association between increased epicardial fat thickness and calcium deposits in the mitral valve annulus that is a degenerative process associated with cardiovascular risk factors.