P2595
The role of epicardial fat thickness and other parameters of visceral adiposity in right ventricular diastolic function in patients with metabolic syndrome

Abstract

Background

Abdominal obesity is associated with an increased risk of cardiovascular disease and all-cause mortality especially in patients with metabolic syndrome (MetS). Despite the undeniable importance of right ventricle (RV) function, little is known about RV diastolic function implication in obesity and MetS.

Purpose

The objective of our study was to evaluate the role of epicardial fat thickness (EFT) and other parameters of visceral obesity in diastolic function of RV in patients with MetS.

Methods

The study included 70 subjects with MetS (mean age 52.6±9.4 years) and 70 controls without MetS (mean age 53.8±7.5 years). MetS was defined by ≥3 criteria of International Diabetes Federation and American Heart Association/National Heart, Lung, and Blood Institute. We assessed RV diastolic function by pulsed wave and tissue Doppler echocardiography and determined the ratio of early (TV E) and late (TV A) trans-tricuspid valve inflow velocities (TV E/A), early tricuspid valve (TV) annular tissue Doppler velocity (TV e'), the TV E/e' ratio and TV deceleration time (DT). Anthropometric and sonographic parameters of visceral adiposity included: waist circumference (WC), waist-to-hip ratio (WHR), visceral adiposity index (VAI), intraabdominal fat thickness (IFT), abdominal wall fat index (AWFI) and epicardial fat thickness (EFT).

Results

Mean values of WC (p=0.030), WHR (p=0.008), VAI (p=0.001), IFT (p=0.035), AWFI (p=0.013) and EFT (p=0.012) were significantly higher in the group with MetS vs. controls. RV diastolic function parameters were also significantly changed in the group with MetS vs controls (tab.1). TV E/e' was positively correlated with WC (r=0.297, p<0.01), WHR (r=0.238, p<0.05), VAI (r=0.271, p<0.05), IFT (r=0.556, p<0.01), AWFI (r=0.604, p<0.01) and EFT (r=0.795, p<0.01). Using multivariate regression analysis EFT, WC and plasma glucose level were the most important predictors for RV diastolic dysfunction in subjects with MetS (p<0.05 for all parameters).

Table 1. RV diastolic function

Variables	MetS (n=70)	Controls (n=70)	p
TV E, cm/s	48±11.1	52.1±14	0.025
TV A, cm/s	56.54±11	52.3±11.7	0.034
TV E/A	0.92±0.4	1.07±0.44	0.029
TV e', cm/s	10.6±2.7	10.7±3.5	0.001
TV E/e'	5.84±1.04	4.59±0.82	0.001
DT, ms	227.9±12.4	217±17.8	0.009

Conclusion

Our findings support that EFT and WC play an important role in RV diastolic dysfunction in patients with MetS.

Diastolic Ventricular Dysfunction