Epikardiyal Yağ Dokusunun Ekokardiografi ve Bilgisayarlı Tomografi ile Değerlendirilmesi

Abstract

Epicardial fat is the visceral fatty deposition of the heart. In the last 10 years, interest in epicardial fat has increased substantially and epicardial fat has been shown to be linked with a number of clinical conditions like metabolic syndrome, atherosclerosis, glucose intolerance, insulin resistance, elevated blood pressure, and fatty liver. The aim of this study is to determine the correlation of the measurements of epicardial fat by multislice computed tomography (MDCT) and transthoracic echocardiography (TTE) and to determine the association of the inflammatory markers, resistin and leptin, with epicardial fat. 200 patients (94 men, 106 women), 30-90 years of age, in whom MDCT angiography was performed according to different clinical indications, were included in this study. Epicardial fat thickness was measured by TTE in the parasternal long axis (PLAX) and parasternal short axis (PSAX) at end-systole and an average of a total of three measurements was taken. In MDCT, epicardial fat thickness was measured at basal, mid and apical portions in short axis and in the right and left atrioventicular grooves and the neighborhood of the right and left ventricles in long axis; this accounted to a total of 29 measurements by MDCT. Average measurements made by MDCT in the superior interventricular groove, inferior interventricular groove, anteroinferior portion of the right ventricle, anterosuperior portion of the right ventricle and superior portion of the right ventricle as well as average measurements in the left ventricular apex, left atrioventricular groove, right atrioventricular groove, and right ventricular apex were found to be correlated with the measurements made by TTE. Univariate analysis revealed an association between epicardial fat thickness measured by TTE and MDCT and age, waist diameter, body mass index, presence of hypertension, HDL, uric acid, and leukocyte count. When the effects of these risk factors were evaluated together, age (TTE: β±SH: 0.012±0.005, p: 0.034; MDCT: β±SH: 0.022±0.008, p: 0.007), HDL level (TTE: β±SH: -0.132±0.006, p: 0.027; MDCT: β±SH: -0.016±0.008, p: 0.044), uric acid level (TTE: β±SH: 0.110±0.056, p: 0.045; MDCT: β±SH: 0.119±0.078, p: 0.011), and leukocyte count (TTE: β±SH: 0.126±0.042, p:0.003; MDCT: β±SH: 0.118±0.058, p: 0.001) were found to be independent predictors of epicardial fat thickness. Resistin and leptin was measured in 80 patients. Resistin (β±SH: 0.276± 0.041, p: 0.001) and leptin (β±SH: 0.068± 0.019, p: 0.002) were evaluated according to age, HDL level, uric acid level and leukocyte count. Both resistin and leptin were found to be independent predictors of epicardial fat thickness.