[Relation between epicardial adipose tissue thickness and blood pressure levels in prehypertension]. / Prehipertansiyonda epikardiyal yag dokusu kalinligi ile kan basinci düzeyleri arasindaki iliski.

OBJECTIVES: Increased epicardial adipose tissue (EAT) thickness is a risk factor for cardiovascular diseases. Previous studies have demonstrated that EAT thickness is increased in patients with hypertension compared with normotensive individuals. In the current study, we aimed to evaluate whether echocardiographically measured EAT thickness differs among patients with normotension, prehypertension, hypertension, and the relation between EAT thickness and blood pressure levels in prehypertensives. STUDY DESIGN: Patients with prehypertension (n=50) and hypertension (n=50) and normotensive healthy subjects (n=50) according to the American Hypertension Guidelines (Joint National Committee 7) were enrolled in the study. All participants underwent transthoracic echocardiographic examination. EAT thickness was measured from the parasternal long-axis view at end-systole. RESULTS: Compared with normotensives, EAT thickness was significantly increased in subjects with prehypertension and hypertension (4.1±1.1 mm, 5.4±1.3 mm and 6.6±1.5 mm, respectively, p<0.001). After adjustment for confounding factors like age, gender, high-density lipoprotein, waist circumference, and body mass index, EAT thickness in the normotensive, prehypertensive and hypertensive groups was measured as 4.3±1.2 mm, 5.3±1.2 mm and 6.4±1.4 mm, respectively (p=0.001). In the prehypertensive group, multivariable linear regression analysis showed that EAT thickness was positively correlated with both systolic (r=0.305, p=0.001) and diastolic (r=0.297, p=0.001) blood pressures, independent of other risk factors. CONCLUSION: In addition to hypertensive subjects, echocardiographically measured EAT thickness is increased in prehypertensive patients when compared with normotensive subjects, independent of other factors. Additionally, increased EAT thickness is significantly correlated with systolic and diastolic blood pressure levels in patients with prehypertension.

Increased echocardiographic epicardial fat thickness and high-sensitivity CRP level indicate diastolic dysfunction in patients with newly diagnosed essential hypertension.

BACKGROUND: Hypertension (HT) is one of the main conditions associated with left ventricular (LV) diastolic dysfunction. Epicardial fat tissue (EFT) serves as a source of a plenty of proinflammatory cytokines and is associated with increased cardiovascular events. The aim of the current study was to evaluate the relation among echocardiographically measured EFT thickness, systemic inflammation, and LV diastolic dysfunction in patients with essential HT. PATIENTS AND METHODS: The study included 135 newly diagnosed and untreated hypertensive outpatients. On the basis of conventional Doppler and tissue Doppler imaging-derived parameters, patients were divided into two groups: 60 patients with normal diastolic function and 75 patients with LV diastolic dysfunction. EFT thickness was measured from the parasternal long-axis view at end-systole and high-sensitivity C-reactive protein (hs-CRP) was assessed using the latex-enhanced immunoturbidimetric method. RESULTS: In patients with LV diastolic dysfunction, EFT thickness was significantly increased compared with the normal diastolic function group (7.9 ± 1.7 vs. 6.3 ± 1.5 mm; P < 0.001, respectively). Serum hs-CRP level was also significantly higher in the LV diastolic dysfunction group (P < 0.001) and was correlated with EFT thickness (r = 0.442, P < 0.001). In stepwise multivariate logistic regression analysis, EFT thickness (odds ratio 1.27, 95% confidence interval 1.12-1.43; P = 0.006) and hs-CRP level (odds ratio 1.42, 95% confidence interval 1.18-1.72; P = 0.003) emerged as independent positive predictors of LV diastolic dysfunction. CONCLUSION: In patients with newly diagnosed and untreated essential HT, increased EFT thickness and hs-CRP level are significantly related to impaired LV diastolic function independent from other factors, including age, waist circumference, and 24-h systolic blood pressure.