Epicardial adipose tissue volume is independently associated with aortic root size as assessed by cardiac magnetic resonance imaging

Background Epicardial adipose tissue (EAT), located between the myo-epicardium and the visceral pericardium, is a metabolically active organ and secretes pro-inflammatory, fibrotic and atherogenic adipokines. The absence of a fascial layer between EAT and aortic adventitia may allow the EAT secretome to alter aortic extracellular matrix promoting aortic root dilatation. Aortic root size has been shown to be an independent predictor of incident heart failure, stroke, and cardiovascular and allcause mortality. The aim of this study was to assess the association of EAT volume with aortic measurements both within and outside the pericardium using cardiac magnetic resonance imaging (CMR).