Epicardial Adipose Tissue Accumulation and Essential Hypertension in Non-Obese Adults

Abstract

Background and Objectives: Epicardial adipose tissue (EAT) is shown to be an important factor in the development of coronary artery disease, but numerous pathophysiological mechanisms of its action are still only partially understood. There is a lack of studies on its association with different grades of essential hypertension (EH). Therefore, we aimed to evaluate the association between size of EAT depots and the risk of EH taking into account its grade. Materials and Methods: Non-obese adult patients with various cardiovascular diseases were investigated: 157 of them had essential hypertension and 101 did not. Hypertensive patients were assigned to three groups according to the grade of hypertension. EAT volume and thickness on ventricular free walls (6 locations) and grooves (5 locations) were measured using cardiac magnetic resonance imaging and compared between groups. A regression model for the prediction of EH was constructed. Results: In general, thickness (in all locations) and volume of EAT depots was greater among hypertensive patients than in normotensive (NORM) group. Mean EAT thickness in all 11 locations and EAT volume were lower in NORM than in grade 1 hypertension group; similarly, EAT volume was lower in grade 1 than in grade 2 hypertension group. EAT accumulation did not differ between grade 2 and severe hypertension groups. EAT volume, dyslipidaemia status, body mass index, and age were independent predictors for EH in regression model. Conclusions: EAT accumulation is larger among hypertensive than normotensive individuals. Measurement of EAT depots could be beneficial for identification of hypertensive patients and prediction of hypertension severity.

Keywords: adults; epicardial fat; grade of hypertension; primary hypertension; risk assessment.

Figure 1

EAT measurements on cardiac magnetic resonance imaging. True fast imaging with steady-state precession (TrueFISP) images of horizontal long-axis (b), (d) and short-axis (a), (c) views in end-diastole were used. (a) and (b) images show measurement of EAT volume: an outlined EAT area (a) in one of the slices (b). (c) and (d) images show measurement of EAT thickness on the right ventricular free wall (RVFW), left ventricular free wall (LVFW), in the superior interventricular groove (SIVG), inferior interventricular groove (IIVG), anterior interventricular groove (AIVG), right atrioventricular groove (RAVG), left atrioventricular groove (LAVG).