Epicardial Fat: An Additional Measurement for Subclinical Atherosclerosis and Cardiovascular Risk Stratification?

Background: The value of epicardial adipose tissue (EAT) thickness as determined by echocardiography in cardiovascular risk assessment is not well understood. The aim of this study was to determine the associations between EAT thickness and Framingham risk score, carotid intima media thickness, carotid artery plaque, and computed tomographic coronary calcium score in a primary prevention population. Methods: Patients presenting for cardiovascular preventive care (n = 356) who underwent echocardiography as well as carotid artery ultrasound and/or coronary calcium scoring were included. Results: EAT thickness was weakly correlated with Framingham risk score. The prevalence of carotid plaque was significantly greater in those with EAT thickness >= 5.0 mm who either had low Framingham risk scores or had body mass indexes >= 25 kg/m(2), compared with those with EAT thickness < 5.0 mm. No significant association between EAT thickness and carotid intima-media thickness or coronary calcium score existed. Conclusion: EAT thickness > 5.0 mm may identify an individual with a higher likelihood of having detectable carotid atherosclerosis. (J Am Soc Echocardiogr 2011;24:339-45.)