ORIGINAL ARTICLE Echocardiographic Measurement of Epicardial Adipose Tissue in Obese Children Osman Ozdemir • Samil Hizli • Ayhan Abaci • Kadir Agladioglu • Sinef Aksoy Received: 13 December 2009 / Accepted: 22 April 2010 / Published online: 13 May 2010 Ó Springer Science+Business Media, LLC 2010 Abstract The echocardiographic measurement of epi- cardial adipose tissue (EAT) has been suggested as an easy method for evaluation of the visceral adipose tissue and its related cardiovascular risks in adults. However, a direct effect of obesity on cardiac function is not well established, and echocardiographic EAT thickness has not been studied in children. The aims of this study were to evaluate cardiac function and echocardiographic EAT thickness and to correlate EAT with the other echocardiographic findings in obese children. The study population included 106 obese and 62 lean children. Echocardiographic indexes of systolic and diastolic function were obtained. We measured EAT thickness on the free wall of the right ventricle from par- asternal long-axis views. The septal and posterior wall thicknesses, relative wall thickness, left atrial diameter, and left ventricular mass were increased (p = 0.001) in obese children. However, systolic and diastolic functions of the left ventricle were normal in the patients. The obese children had a significantly thicker EAT (p = 0.001) compared to the lean subjects. EAT thickness correlated significantly with body mass index (r = 0.50, p = 0.001), left atrial diameter (r = 0.37, p = 0.001), and left ven- tricular mass (r = 0.33, p = 0.001). In conclusion, the present study demonstrates a close relationship between EAT thickness and obesity in children. Assessment of EAT thickness in routine echocardiographic examinations might be used as a feasible and reliable method for the evaluation of obesity and its related cardiovascular risks during childhood. Keywords Childhood obesity Á Echocardiography Á Epicardial adipose tissue Á Epicardial fat The prevalence of obesity in children has more than tripled from 1980 to 2002. The prevalence is approximately 16% for children in the United States [12]. This increase in the prevalence of obesity appears to be occurring worldwide. The prevalence of obesity in developing countries has accelerated over the past two decades. These dramatic changes make obesity a major issue of public health [5]. The development of obesity in childhood is a major determinant of cardiovascular risk later in life [8]. When a child is evaluated for obesity, it is important that assess- ment of cardiovascular risk factors be included as part of the evaluation. The association between left ventricular (LV) systolic dysfunction and obesity has been documented in adults for more than 20 years [4]. Recent studies have demonstrated that an abnormality of LV diastolic filling is present without systolic dysfunction in obese adult patients [23]. There have been some recent reports that obesity causes echocardiographic findings of increased left atrial (LA) O. Ozdemir (&) Department of Paediatric Cardiology, Kecioren Training and Research Hospital, Sanatoryum Caddesi, Pinarbasi Mahallesi, Ardahan Sokak, Kecioren Egitim ve Arastirma Hastanesi, Ankara, Turkey e-mail: pedkard@gmail.com S. Hizli Department of Paediatric Gastroenterology, Hepatology and Nutrition, Kecioren Training and Research Hospital, Ankara, Turkey A. Abaci Department of Paediatric Endocrinology, Kecioren Training and Research Hospital, Ankara, Turkey K. Agladioglu Á S. Aksoy Department of Radiology, Kecioren Training and Research Hospital, Ankara, Turkey 123 Pediatr Cardiol (2010) 31:853–860 DOI 10.1007/s00246-010-9720-y