Gustafsson B, Rovio S P, Ruohonen S, Mykkänen J, Lehtimäki T, Jokinen E, Tossavainen P, Laitinen T P, Kähönen M, Viikari J S A, Pahkala K, Raitakari O T
Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
Eur J Prev Cardiol. 2025 Jul 2. doi: 10.1093/eurjpc/zwaf394.
Previous studies who have reported associations between higher epicardial adipose tissue (EAT) and alterations in cardiac geometry and function are mainly derived from older adults. In this cross-sectional study, we examined whether these relations are also seen in the young and middle-aged study population of the Cardiovascular Risk in Young Finns Study (YFS).
Echocardiography was performed (N=1667) and echocardiographic metrics were derived according to European Association of Echocardiography guidelines. EAT thickness was measured from parasternal long axis echocardiograms at end-systole. Multivariable linear regression analysis was used to study the associations between EAT thickness and echocardiographic metrics. Possible effect modification by sex was analysed.
Direct associations were observed between higher EAT and left ventricular (LV) wall thickness parameters [(LV mean (back-transformed β=0.72%, P=0.002), relative (back-transformed β=0.64%, P=0.002) and posterior wall thickness (β=0.0005, P=0.0002)] and left atrium (LA) size (β=0.02, P=0.001), while an inverse association of higher EAT and decreased mitral annular velocity (e') (back-transformed β=-1.0 %, P=0.02) was found after adjustments for age, sex, waist circumference and systolic blood pressure.
Our results suggest associations between EAT thickness, increased LV wall thickness, LA size, and decreased mitral annular velocity in early adulthood. The observed alterations in these specific cardiac metrics are particularly known as early structural alterations linked with obesity-related LV concentric remodeling and relaxation abnormalities. Thus, EAT may contribute in cardiac subclinical remodelling initiating in early adulthood, which may lead to various cardiovascular outcomes later in life. However, due to the modest effect sizes observed, further studies are required to assess the magnitude of these associations over long-term follow-up.
既往有研究报道了较高的心外膜脂肪组织（EAT）与心脏几何形态和功能改变之间的关联，这些研究主要来自老年人。在这项横断面研究中，我们调查了在年轻芬兰人心血管风险研究（YFS）的中青年研究人群中是否也存在这些关系。
对1667名受试者进行了超声心动图检查，并根据欧洲超声心动图协会指南得出超声心动图指标。在收缩末期从胸骨旁长轴超声心动图测量EAT厚度。采用多变量线性回归分析来研究EAT厚度与超声心动图指标之间的关联。分析了性别可能产生的效应修正作用。
较高的EAT与左心室（LV）壁厚度参数[LV平均厚度（反向转换β=0.72%，P=0.002）、相对厚度（反向转换β=0.64%，P=0.002）和后壁厚度（β=0.0005，P=0.0002）]以及左心房（LA）大小（β=0.02，P=0.001）之间存在直接关联，而在对年龄、性别、腰围和收缩压进行调整后，发现较高的EAT与二尖瓣环速度（e'）降低（反向转换β=-1.0%，P=0.02）之间存在负相关。
我们的结果表明，在成年早期，EAT厚度、LV壁厚度增加、LA大小增加以及二尖瓣环速度降低之间存在关联。这些特定心脏指标中观察到的改变尤其被认为是与肥胖相关的LV向心性重塑和舒张功能异常相关的早期结构改变。因此，EAT可能在成年早期启动的心脏亚临床重塑中起作用，这可能在以后的生活中导致各种心血管结局。然而，由于观察到的效应量较小，需要进一步研究来评估这些关联在长期随访中的程度。
