Ultrasound evaluation of epicardial fat and Eco-Obesity body composition assessment

Objectives: To validate echocardiographic epicardial adipose tissue (EAT) thickness as a non-invasive marker of cardiometabolic risk in obesity and compare Eco-Obesity ultrasound-derived measurements of epicardial, preperitoneal, omental, and peri-renal fat depots with standard body composition analysis by dual-energy X-ray absorptiometry (DEXA). Methods: In a cross-sectional study of 402 adults with obesity attending two Barcelona centers, Eco-Obesity ultrasound was performed in 114 subjects, alongside DEXA scans. Thickness of epicardial and abdominal fat depots, metabolic markers, and anthropometric indices were measured using standardized protocols. Relationships among ultrasound fat measurements, DEXA indices, anthropometric variables, and biochemical markers were analyzed by Pearson correlation coefficients; subgroup comparisons used ANOVA. Results: Moderate (>7mm) and severe (>10mm) EAT thickness were found in 35.6% and 53.1% of patients. EAT measured in long-axis, short-axis, and posterior cardiac recess (PPR) projections correlated significantly with BMI, waist circumference, and waist-to-height ratio (all p