Epicardial fat in patients with metabolic syndrome

Metabolic syndrome (MS) is bundling of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure. Epicardial fat (EPF) plays a role in cardiovascular diseases because of its anatomic and functional proximity to the myocardium and intense metabolic activity. Assess EPF in patients with MS using echocardiography and find its relation to its parameters 200 patients with criteria of MS according to National Cholesterol Education Program's Adult Treatment Panel III were subjected to clinical examination, echocardiography; where EPF (end-systolic thickness of echo free space in front of the free wall of right ventricle) was measured, abdominal ultrasonography for detection of non alcoholic fatty liver disease (NAFLD) and lipid and liver profiles. Fasting blood sugar (FBS), uric acid (UA) and hs-CRP were assessed as well. Patients were classified into two groups, group 1; 176 patients with EPF and group 2,28 patients with no EPF. 55% patients in group 1 were females vs 50% in group 2. Patients in group 1 had higher waist circumference (WC) 123 ± 7 vs 107 ± 2, p < 0.05, higher triglycerides level 240 ± 45 vs 181 ± 40, p < 0.05, higher filling pressure 16 ± 2 vs 11 ± 3, p < 0.05, and higher (ALT) 88 ± 17 vs 42 ± 7, p < 0.05. 28% of patients in group 1 had high hs-CRP, and 89% have NAFLD. EPF correlated significantly with WC, r = 0.45, NAFLD, r = 0.48, filling pressure, r = 0.39, and hs-CRP r = 0.57. EPF as measured by echocardiography reflects visceral fat and severe MS. Echocardiography is an easy and reliable imaging technique to classify patients with high risk.