Background: Epicardial adipose tissue (EAT) is a metabolically active visceral fat located between the myocardium and the visceral pericardium. Increased epicardial fat thickness (EFT) has been shown as a novel cardiovascular risk factor in some recent studies (1), (2) and have been suggested as a marker for cardiovascular risk stratification. Few studies have studied EFT in patients with SpA.

Objectives: The aim of our study was to assess the relationship between EFT and Patient-Reported Outcomes (PROs) in SpA patients.

Methods: We conducted a case control study over a 12 months period. Patients diagnosed with SpA according to ASAS 2009 criteria and age and sex matched controls were included. All subjects were aged less than 50 years old and without cardiovascular risk factors. Clinical data related to the disease were collected. Patient-Reported Outcomes (PROs): morning stiffness duration, nocturnal awakenings, pain visual analog scale (VAS) and patient global assessment (PGA) were recorded. BASG-s (Bath Ankylosing Spondylitis-Global score) was also raised. All patients underwent echocardiographic examination with measurement of EFT.

Results: We included 94 subjects (47 patients and 47 controls), sex ratio was 2.35, and median age was 36 years (IQR: 18-32). Median disease duration was 11 years (IQR: 5-16). Median disease activity scores BASDAI and ASDAS-CRP were 2.6 (IQR: 1.8-3.8) and 2.18 (IQR: 1.62-2.91) respectively. Regarding Patient-Reported Outcomes (PROs); median duration of morning stiffness was 5 minutes (IQR: 0-180) and median number of nocturnal awakenings was 0 (IQR: 0-2). Median VAS pain and median PGA were 50 (IQR: 30-60) and 40 (IQR: 30-60), respectively. Median EFT was significantly increased in SpA patients 3.1 mm (IQR: 2.5-4) compared with healthy controls 2.4 mm (IQR: 2-3) (p=0.001).

EFT was positively correlated with VAS pain (p=0.012; r=0.363) and BASG-s (p=0.025; r=0.327). No significant association was found between EFT and Morning stiffness duration (p=0.164; r=0.206), Nocturnal awakenings (p=0.463; r=0.11) and PGA (p=0.07; r=0.267).

In multivariate linear regression analysis, pain visual analog scale was found to be independently associated with EFT (B=0.126; 95% Confidence Interval: 0.017-0.236; p=0.025).

Conclusion: EFT measurement as an early marker of atherosclerosis was associated with pain and BASG score.

REFERENCES:

[1]Mahabadi AA, Lehmann N, Kälsch H, Robens T, Bauer M, Dykun I, et al. Association of epicardial adipose tissue with progression of coronary artery calcification is more pronounced in the early phase of atherosclerosis: results from the Heinz Nixdorf recall study. JACC Cardiovasc Imaging. 2014 Sep;7(9):909–16.

[2]Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, et al. Pericardial Fat, Visceral Abdominal Fat, Cardiovascular Disease Risk Factors, and Vascular Calcification in a Community-Based Sample. Circulation. 2008 Feb 5;117(5):605–13.

Disclosure of Interests: None declared