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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:254-60 - Vol. 70 Num.04 DOI: 10.1016/j.rec.2016.08.001

Epicardial Adipose Tissue in the General Middle-aged Population and Its Association With Metabolic Syndrome

Álvaro Calabuig a,, Joaquín Barba a,b, María Jesús Guembe b,c, Javier Díez a,b,d, Jesús Berjón b,e, Eduardo Martínez-Vila b,f, Pablo Irimia b,f, Estefanía Toledo b,g,h

a Departamento de Cardiología y Cirugía Cardiovascular, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain
b Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
c Servicio de Planificación, Evaluación y Gestión del Conocimiento, Sección de Formación, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, Spain
d Programa de Enfermedades Cardiovasculares, Centro de Investigación Médica Aplicada, Universidad de Navarra, Pamplona, Navarra, Spain
e Servicio de Cardiología, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
f Departamento de Neurología, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain
g Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, Navarra, Spain
h Centro de Investigación Biomédica en Red (CIBER) - Fisiopatología de la Obesidad y Nutrición, Madrid, Spain


Epicardial fat. Metabolic syndrome. Transthoracic echocardiography. General population. RIVANA Study.


Introduction and objectives

There is currently increasing interest in epicardial adipose tissue (EAT) as a marker of cardiovascular disease. Our purpose was to describe EAT, measured by transthoracic echocardiography, and to assess its association with metabolic syndrome (MS) in the RIVANA population-based study.


Physical examination was performed in 880 participants aged 45 to 74 years (492 of them with MS according to the harmonized definition). Fasting glucose, high-density lipoprotein cholesterol, triglyceride, and C-reactive protein concentrations were determined in a blood sample. In all participants, EAT thickness was measured with transthoracic echocardiography at end-systole.


Among participants without MS, the prevalence of EAT ≥ 5 mm significantly increased with age (OR > 65 years vs 45-54 years = 8.22; 95%CI, 3.90-17.35; P for trend < .001). Increasing EAT quintiles were significantly associated with MS (OR fifth quintile vs first quintile = 3.26; 95%CI, 1.59-6.71; P for trend = .001). Considering the different MS criteria, increasing quintiles of EAT were independently associated with low high-density lipoprotein cholesterol (OR fifth quintile vs first quintile = 2.65; 95%CI, 1.16-6.05; P for trend = .028), high triglycerides (OR fifth quintile vs first quintile = 2.22; 95%CI, 1.26-3.90; P for trend = .003), and elevated waist circumference (OR fifth quintile vs first quintile = 6.85; 95%CI, 2.91-16.11; P for trend < .001).


In a subsample of the general population, EAT measured by echocardiography increased significantly and independently with age. Increased EAT thickness was independently associated with MS and with low high-density lipoprotein cholesterol, high triglycerides, and elevated waist circumference as individual criteria.


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1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved