Epicardial fat from echocardiography: A new method for visceral adipose tissue prediction
Abstract
OBJECTIVE: To validate transthoracic echocardiography as an easy and reliable imaging method for visceral adipose tissue (VAT) prediction. VAT is recognized as an important indicator of high cardiovascular and metabolic risk. Several methods are applied to estimate VAT, with different results. RESEARCH METHODS AND PROCEDURES: We selected 60 healthy subjects (29 women, 31 men, 49.5 +/- 16.2 years) with a wide range of body mass indexes. Each subject underwent transthoracic echocardiogram and magnetic resonance imaging (MRI) to measure epicardial fat thickness on the right ventricle. Measurements of epicardial adipose tissue thickness were obtained from the same echocardiographic and MRI views and points. MRI was also used to measure VAT cross-sectional areas at the level of L4 to L5. Anthropometric indexes were also measured. RESULTS: Subjects with predominant visceral fat accumulation showed higher epicardial adipose tissue thickness than subjects with predominant peripheral fat distribution: 9.97 +/- 2.88 vs. 4.34 +/- 1.98 (p = 0.005) and 7.19 +/- 2.74 vs. 3.43 +/- 1.64 (p = 0.004) in men and women, respectively. Simple linear regression analysis showed an excellent correlation between epicardial adipose tissue and waist circumference (r = 0.895, p = 0.01) and MRI abdominal VAT (r = 0.864, p = 0.01). Multiple regression analysis showed that epicardial adipose tissue thickness (r(2) = 0.442, p = 0.02) was the strongest independent variable correlated to MRI VAT. Bland test confirmed the good agreement between the two methods. DISCUSSION: Epicardial adipose tissue showed a strong correlation with anthropometric and imaging measurements of VAT. Hence, transthoracic echocardiography could be an easy and reliable imaging method for VAT prediction.
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Echocardiography is limited by a high dependency on operator expertise and a linear measurement at a single location, which fails to take account for the site variability of epicardial fat thickness.
“While rapid, relatively inexpensive, and widely available, this technique is limited by a high dependency on operator expertise and a linear measurement at a single location, which fails to take account for the site variability of epicardial fat thickness [109].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [109]
EAT is higher in subjects with T2DM and metabolic syndrome, independently of traditional body fat indicators.
“Epicardial adipose tissue is higher in subjects with T2DM and metabolic syndrome, independently of traditional body fat indicators [5–7].”
From Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity (2020) · cites this paper as [6]
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- Authors
- Iacobellis, G., Assael, F., Ribaudo, M. C., Zappaterreno, A., Alessi, G., Di Mario, U., & Leonetti, F.
- Affiliations
- Sapienza University of Rome (IT)
- Azienda Ospedaliera San Camillo-Forlanini (IT)
- Corresponding author
- Iacobellis, Gianluca
- Venue
- Obesity Research
- Publisher
- Wiley
- Published
- 2003-02
- Volume
- 11
- Issue
- 2
- Pages
- 304-310
- ISSN
- 1071-7323 (ISSN-L)
- 1550-8528
- OpenAlex
- W2053299529
- Cited by
- 779
- References
- 34
- Citations by year
- 2026: 24 · 2025: 33 · 2024: 32 · 2023: 30 · 2022: 42 · 2021: 42 · 2020: 50 · 2019: 48 · 2018: 41 · 2017: 37 · 2016: 44 · 2015: 59 · 2014: 58 · 2013: 62 · 2012: 36
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Research (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- epicardial adipose tissue, visceral adipose tissue, transthoracic echocardiography, right ventricle, waist circumference, body mass index, body fat distribution, cardiovascular risk
- MeSH terms
- Adipose Tissue, Adult, Aged, Body Composition, Body Constitution, Echocardiography, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pericardium, Regression Analysis, Viscera, Linear Models
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