A1 Refereed original research article in a scientific journal
Association of epicardial adipose tissue thickness and cardiac structure and function in early midlife: the cardiovascular risk in Young Finns Study
Authors: Gustafsson, Behnoush; Rovio, Suvi P.; Ruohonen, Saku; Mykkänen, Juha; Lehtimäki, Terho; Jokinen, Eero; Tossavainen, Päivi; Laitinen, Tomi P.; Kähönen, Mika; Viikari, Jorma S.; Pahkala, Katja; Raitakari, Olli T.
Publisher: Oxford University Press (OUP)
Publishing place: OXFORD
Publication year: 2025
Journal: European Journal of Preventive Cardiology
Journal name in source: European Journal of Preventive Cardiology
Journal acronym: EUR J PREV CARDIOL
Article number: zwaf394
Number of pages: 10
ISSN: 2047-4873
eISSN: 2047-4881
DOI: https://doi.org/10.1093/eurjpc/zwaf394
Web address : https://doi.org/10.1093/eurjpc/zwaf394
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/499692525
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.
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Funding information in the publication:
The YFS has been financially supported by the Academy of Finland: Grants 356405, 322098, 286284, 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi), and 141071 (Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research; Finnish Cultural Foundation; The Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjoe Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; EU Horizon 2020 (grant 755320 for TAXINOMISIS and grant 848146 for To_Aition); European Research Council (grant 742927 for MULTIEPIGEN project); Tampere University Hospital Supporting Foundation; Finnish Society of Clinical Chemistry; the Cancer Foundation Finland; pBETTER4U_EU (Preventing obesity through Biologically and bEhaviorally Tailored inTERventions for you; project number: 101080117); CVDLink (EU Horizon grant no. 101137278); the Jane and Aatos Erkko Foundation. K Pahkala is supported by an Research Council of Finland Researcher Fellowship (no. 322112). In addition, this study has been made feasible with the personal funds provided to Behnoush Gustafsson by Turku University Graduate school, Turku University research fund, Paulo's foundation. Instrumentarium research foundation and Paeivikki and Sakari Sohlberg foundation.
