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Epicardial fat thickness may predict NAFLD, heart rate recovery

Data from a recent study has associated non-alcoholic fatty liver disease and epicardial fat thickness with heart rate recovery in patients with metabolic syndrome.

“Our study suggests that echocardiographic [epicardial fat thickness] is a better predictor of ultrasound-measured NAFLD in [metabolic syndrome] than BMI or [waist circumference]. Because epicardial fat and fatty liver represent organ-specific ectopic fat accumulations that reflect visceral adiposity, they may share similar biochemical properties,” Kyoung Im Cho, MD, PhD, from the Kosin University College of Medicine, South Korea, and colleagues wrote.

The researchers enrolled 772 patients from a health-screening center between January 2010 and March 2015. The study included 210 patients with metabolic syndrome and 562 patients without metabolic syndrome. All patients underwent abdominal ultrasonography, an exercise treadmill test and cardiac echocardiography.

Exercise time and metabolic equivalents were significantly lower in patients with metabolic syndrome compared with patients without metabolic syndrome (P < .05).

Combined metabolic syndrome and NAFLD, present in 141 patients, were associated with older age (P = .001), male sex (P < .001) and high BMI (P < .001) compared with patients without metabolic syndrome. All patients with NAFLD, especially those with metabolic syndrome, had significantly higher epicardial fat thickness (P < .001) and significantly lower heart rate recovery (P = .01) compared with patients without NAFLD.

The 24 patients with severe liver steatosis also had significantly higher epicardial fat thickness (P < .001) and lower heart rate recovery (P < .001) compared with patients with moderate liver steatosis.

Overall, epicardial fat thickness was significantly correlated with heart rate recovery (r = –0.386; P < .001) and was determined to be an independent predictor of NAFLD (after adjustment for age, waist circumference, BMI and cardiovascular risk factors) as well as impaired heart rate recovery.

“These results suggest a relation among epicardial fat, [liver steatosis] and autonomic dysfunction in [metabolic syndrome]. In addition, we also found a significant link between exercise capacity and [epicardial fat thickness] in our study. In view of the prognostic importance of impaired [heart rate recovery] and exercise capacity, these results suggest that [epicardial fat thickness] plays a role in development of adverse [cardiovascular] outcomes in [metabolic syndrome],” the researchers concluded. “However, the prognostic impacts of blunted [heart rate recovery] in the current study population, who participated in a health checkup, are beyond the scope of this study. Instead, we emphasized the clinical implications of our data.” – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.