The main aim of the present study was to investigate the association between epicardial adipose tissue (EAT) and arterial function in patients with asymptomatic hypertension. Patients with hypertension (n = 155) were enrolled consecutively. Patients with decreased arterial compliance (AC) and increased cardioankle vascular index (CAVI) had higher EAT values compared with those with normal AC and CAVI (6.23 ± 1.67 vs 4.91 ± 1.40, P < .001 and 6.02 ± 1.61 vs 4.96 ± 1.46, P = .01, respectively). Analysis using the receiver–operating characteristics curve demonstrated that EAT 5.5 mm constitutes the cutoff value for the presence of increased CAVI with 67% sensitivity and 62% specificity (area under the curve [AUC]: 0.702, 95% confidence interval [CI] 0.590-0.814) and decreased AC with 77% sensitivity and 65% specificity (AUC: 0.756, 95% CI 0.645-0.867). Assessment of EAT during echocardiography examination may provide information on arterial function in patients with asymptomatic hypertension. The link between EAT and arterial stiffness deserves further investigation.
LewingtonSClarkeRQizilbashNPeloRCollinsR. Age-specific relevance of usual blood pressure to vascular mortality. Lancet. 2002;360(9349):1903–1913.
2.
HaluskaBAJeffriesLCarlierSMarwickTH. Measurement of arterial distensibility and compliance to assess prognosis. Atherosclerosis. 2010;209(2):474–480.
3.
ManciaGDe BackerG, Dominiczak A, et al. 2007 guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25(6):1105–1187.
4.
KatsikiNMikhailidisDPWierzbickiAS.Epicardial fat and vascular risk: a narrative review. Curr Opin Cardiol. 2013;28(4):458–463.
5.
ShiraiKHirutaNSongM. Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb. 2011;18(11):924–938.
MohtyDPibarotPEchahidiN. Reduced systemic arterial compliance measured by routine Doppler echocardiography: a new and independent predictor of mortality in patients with type 2 diabetes mellitus. Atherosclerosis. 2012;225(2):353–358.
8.
EliasMFRobbinsMABudgeMMAbhayaratnaWPDoreGAEliasPK. Arterial pulse wave velocity and cognition with advancing age. Hypertension. 2009;53(4):668–673.
9.
MitchellGF. Arterial stiffness and wave reflection in hypertension: pathophysiologic and therapeutic implications. Curr Hypertens Rep. 2004;6(6):436–441.
10.
MitchellGFHwangSJVasanRS. Arterial stiffness and cardiovascular events: the Framingham heart study. Circulation. 2010;121(4):505–511.
11.
VlachopoulosCAznaouridisKStefanadisC. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–1327.
12.
CelikAOzçetinMYerliY. Increased aortic pulse wave velocity in obese children. Turk Kardiyol Dern Ars. 2011;39(7):557–562.
13.
Willum-HansenTStaessenJATorp-PedersenC. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006;113(5):664–70.
14.
ShiraiKUtinoJOtsukaKTakataM. A novel blood pressure-independent arterial wall stiffness parameter; cardio-ankle vascular index (CAVI). J Atheroscler Thromb. 2006;13(2):101–107.
15.
KubozonoTMiyataMUeyamaK. Clinical significance and reproducibility of new arterial distensibility index. Circ J. 2007;71(1):89–94.
16.
NakamuraKTomaruTYamamuraSMiyashitaYShiraiKNoikeH. Cardio-ankle vascular index is a candidate predictor of coronary atherosclerosis. Circ J. 2008;72(4):598–604.
17.
TakakiAOgawaHWakeyamaT. Cardio-ankle vascular index is superior to brachial-ankle pulse wave velocity as an index of arterial stiffness. Hypertens Res. 2008;31(7):1347–1355.
18.
MasugataHSendaSInukaiM. Association of cardio-ankle vascular index with brain natriuretic peptide levels in hypertension. J Atheroscler Thromb. 2012;19(3):255–262.
19.
ParkHEChoiSYKimMKOhBH. Cardio-ankle vascular index reflects coronary atherosclerosis in patients with abnormal glucose metabolism: assessment with 256 slice multi-detector computed tomography. J Cardiol. 2012;60(5):372–376.
20.
OkuraTWatanabeSKurataM. Relationship between cardio-ankle vascular index (CAVI) and carotid atherosclerosis in patients with essential hypertension. Hypertens Res. 2007;30(4):335–340.
21.
SatohNShimatsuAKatoY. Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertens Res. 2008;31(10):1921–1930.
22.
BeltranAMcVeighGMorganD. Arterial compliance abnormalities in isolated systolic hypertension. Am J Hypertens. 2001;14(10):1007–1011.
23.
FagardRHPardaensKStaessenJAThijsL. The pulse pressure-to-stroke index ratio predicts cardiovascular events and death in uncomplicated hypertension. J Am Coll Cardiol. 2001;38(1):227–231.
24.
LaurentSCaviezelBBeckL. Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension. 1994;23(2):878–883.
KimBJKimBSKangJH. Echocardiographic epicardial fat thickness is associated with arterial stiffness [published online June 21, 2012]. Int J Cardiol. 2012. doi:10.1016/j.ijcard.2012.06.013.
27.
StefanadisCDernellisJVlachopoulosC. Aortic function in arterial hypertension determined by pressure–diameter relation: effects of diltiazem. Circulation. 1997;96(6):1853–1858.
28.
PannierBMAvolioAPHoeksAManciaGTakazawaK. Methods and devices for measuring arterial compliance in humans. Am J Hypertens. 2002;15(8):743–753.
29.
NakanishiNSuzukiKTataraK. Clustered features of the metabolic syndrome and the risk for increased aortic pulse wave velocity in middle-aged Japanese men. Angiology. 2003;54(5):551–559.
30.
ChoiKMLeeKWSeoJA. Relationship between brachial-ankle pulse wave velocity and cardiovascular risk factors of the metabolic syndrome. Diabet Res Clin Pract. 2004;66(1):57–61.
31.
Teijeira-FernandezEEirasSGrigorian-ShamagianLFernandezAAdrioBGonzalez-JuanateyJR. Epicardial adipose tissue expression of adiponectin is lower in patients with hypertension. J Hum Hypertens. 2008;22(12):856–863.
32.
ShargorodskyMBoazMGoldbergY. Diponectin and vascular properties in obese patients: is it a novel biomarker of early atherosclerosis?Int J Obes. 2009;33(5):553–558.
33.
ChatterjeeTKStollLLDenningGM. Proinflammatory phenotype of perivascular adipocytes: influence of high-fat feeding. Circ Res. 2009;104(4):541–549.
