Association of epicardial adipose tissue thickness and cardiac structure and function in early midlife - The cardiovascular risks in Young Finns Study

Abstract Aims 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). Methods 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. Results 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. Conclusion 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.