Key result
Higher epicardial fat thickness links to worse diastolic function in young adults with metabolic syndrome.
Why the study?
Data linking metabolic syndrome and epicardial fat to diastolic dysfunction are mostly derived from older populations, with scarce data in youth and early adulthood.
Does epicardial fat thickness modify the association between metabolic syndrome and subclinical diastolic dysfunction in young and middle-aged adults?
Cohort (n=1,667)
Yes
Does epicardial fat thickness modify the association between metabolic syndrome and subclinical diastolic dysfunction in young and middle-aged adults?
p-value: p=<0.0001
Higher epicardial fat thickness is independently associated with adverse alterations in cardiac diastolic function in young and middle-aged adults with metabolic syndrome.
No immediate clinical implications for epicardial fat assessment in metabolic syndrome; extends prior diastolic dysfunction associations to younger adults but remains hypothesis-generating.
Background Associations of metabolic syndrome (METs) with diastolic dysfunction and poor cardiovascular outcomes have been addressed. Epicardial fat (EF) is also reported to link with diastolic dysfunction. 1-3 However, majority of currently known data on these associations are derived from older study populations. Data is scarce on these associations in youth and early adulthood. In order to minimize the confounding effects of aging and other possible age-related cardiometabolic comorbidities, studies from younger study populations are needed. Purpose We aimed to study the associations between METs and diastolic function in a large cohort of young and middle-aged adults and to further seek if these associations may differ by higher EF in these individuals. Methods This study is a part of multi-centre longitudinal Cardiovascular Risk in Young Finns Study (YFS; N = 1667; age 34–49 years). Echocardiography was performed and Tissue Doppler (TD) parameters of left ventricular filling pressure and diastolic function were derived. EF thickness was measured manually from parasternal long axis echocardiograms and median EF thickness was used to define EF groups. Multivariable-adjusted linear regression models were used to seek for the associations of metabolic syndrome and diastolic function metrics in high versus low EF groups. Results EF thickness mean and median values were respectively 4.0mm and 3.8 mm in whole population. METs prevalence was 21.3 % in total population and 12.3% in men vs. 9.0 % in women (P<.001). Mean values for EF thickness was higher in the METs group compared to non-MET(P=0.001). E/e’ ratio as the TD parameter of LV diastolic filling pressure was higher in METs group (P=<.0001) but it did not differ significantly between EF subgroups in METs. Age, sex and BMI adjusted linear regression analysis showed direct significant associations of E/e’ ratio (indicative parameter of LV filling pressure) and inverse association of mitral annular velocity e’ (indicative TD parameter of myocardial relaxation ) with METs, while no associations was observed with left atrial volume index in high EF subgroup. However, similar associations between METs and above-mentioned diastolic function parameters were not observed in low EF subgroup. Conclusion Our findings suggest that EF may independently link with adverse alteration in cardiac diastolic function observed in subjects with METs.
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Gustafsson et al. (2025) conducted a cohort in Metabolic syndrome (n=1,667). Metabolic syndrome vs. Without metabolic syndrome was evaluated on Diastolic function parameters (E/e' ratio and e' velocity) (p=<0.0001). Metabolic syndrome was significantly associated with worse diastolic function (higher E/e' ratio, P<0.0001), an association present in individuals with high, but not low, epicardial fat.
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