The Role of Epicardial Obesity in the Development of Structural and Functional Remodeling of the Heart

Aim. To perform the comparison of the heart structural and functional parameters in abdominal obesity patients depending on the presence epicardial fat tissue verified by echocardiographically defined thickness of the fat deposition. Material and methods. Totally, 108 normotensive males included, with no clinical signs of cardiovascular diseases, age 46-55 y. o. (mean age 48,7±2,0 y. o.), with abdominal obesity (waist circumference >94 cm). The assessment included lipid profile and glycemia, echocardiography, bifunctional ambulatory blood pressure monitoring with the assessment of pulse wave velocity (PWV) in aorta, and augmentation index. Results. Epicardial obesity patients had higher left ventricle (LV) myocardial mass index (119,4±8,9 g/m2 vs 100,4±15,9 g/m2, р<0,001, 47,9±5,3 g/m2,7 vs 39,2±6,7 g/m2,7, р<0,001), index of the relative LV walls thickness (0,42±0,03 vs 0,39±0,04, р<0,01), index of the left atrium volume (22,3±3,4 mL/m2 vs 20,1±2,2 mL/m2, р<0,01), PWV in aorta (8,4±0,4 m/s vs 7,6±0,4 m/s, р<0,001) and augmentation index (-39,4±12,2% vs -46,3±10,6%, р<0,01). In the group of epicardial obesity patients there was more prevalentLV hypertrophy (25,9% (33,3%) vs 6,2% (7,4%), р<0,01) and echo signs of diastolicLV dysfunction (74,8% vs 11,1%, р<0,01). Conclusion. The association revealed, of the epicardial obesity defined by echo assessment of epicardial fat thickness, with parameters of structural and functional remodeling of the heart. Epicardial obesity patients have higher indexed values ofLV myocardial mass and left atrium volume, more prevalent hypertrophy and diastolicLV dysfunction, which does, probably, underlie the development of chronic heart failure and rhythm disorders.