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Open AccessArticle

Association of Cardiovascular Health with Epicardial Adipose Tissue and Intima Media Thickness: The Kardiovize Study

International Clinical Research Center, St’Anne University Hospital, Brno 60200, Czech Republic
Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, Italy
Department of Internal Medicine – Cardioangiology, Faculty of Medicine, Masaryk University, Brno 65691, Czech Republic
Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
Division of Medicine, University College London (UCL), London, NW3 2PF, UK
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2018, 7(5), 113;
Received: 14 April 2018 / Revised: 8 May 2018 / Accepted: 10 May 2018 / Published: 13 May 2018
(This article belongs to the Section Cardiology)
Background: Intima-media thickness (IMT) has been proposed as a measurement of subclinical atherosclerosis and has been associated with cardiovascular disease (CVD). Epicardial adipose tissue (EAT) is a fat depot between the pericardium and myocardium and has been associated with coronary atherosclerosis. The relationship between IMT and EAT thickness has not been reported before. We investigated the relationship between EAT thickness, IMT, CVD risk factors, and ideal cardiovascular health (CVH) metrics using subjects from the Kardiovize Brno 2030 cohort study, a random urban sample population in Central Europe. Methods: We studied 102 individuals (65 males) aged 25–64 years (median = 37 years) with no current or past CVD history. We measured IMT using a vascular ultrasound and EAT thickness using transthoracic echocardiography, and collected data on anthropometric factors, CVD risk factors, and CVH score. Correlation tests and multiple linear regression models were applied. Results: In the age- and gender-adjusted model, we demonstrated that, among CVD risk factors, only BMI was significantly and positively associated with EAT thickness (β = 0.182, SE = 0.082, p = 0.030), while no significant associations with IMT were evident. Although both EAT thickness and IMT were negatively correlated with CVH score (r = −0.45, p < 0.001, and r = −0.38, p < 0.001, respectively), we demonstrated that overall CVH score (β = −0.262; SE = 0.077; p = 0.001), as well as BMI (β = −1.305; SE = 0.194; p < 0.001) and blood pressure CVH metrics (β = −0.607; SE = 0.206; p = 0.004) were significantly associated with EAT thickness but not with IMT. Conclusions: Our study is important as it demonstrated for the first time that CVH is associated with EAT thickness. Interestingly, this relationship seems to be dependent on BMI and blood pressure rather than on the other CVH metrics. However, outcome-driven studies are required to confirm these findings. View Full-Text
Keywords: cardiovascular risk; epicardial adipose tissue; intima media thickness cardiovascular risk; epicardial adipose tissue; intima media thickness
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Hruskova, J.; Maugeri, A.; Podroužková, H.; Štípalová, T.; Jakubík, J.; Barchitta, M.; Medina-Inojosa, J.R.; Homolka, M.; Agodi, A.; Kunzova, S.; Sochor, O.; Lopez-Jimenez, F.; Vinciguerra, M. Association of Cardiovascular Health with Epicardial Adipose Tissue and Intima Media Thickness: The Kardiovize Study. J. Clin. Med. 2018, 7, 113.

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