Background: Epicardial adipose tissue has emerged as an important indicator of visceral fat accumulation and has been implicated in the development of cardiovascular and metabolic disorders through its local inflammatory and paracrine effects. Although increased epicardial fat has been associated with impaired myocardial performance, its relationship with regional myocardial contractility in individuals with hepatic steatosis remains insufficiently characterized. This pilot study aimed to investigate the association between epicardial fat thickness, regional myocardial hypokinesis, and hepatic steatosis.

Materials and Methods: This cross-sectional study enrolled 60 consecutive patients, including 38 men and 22 women, with a mean age of 55.7 ± 18.2 years. Epicardial fat thickness was measured by transthoracic echocardiography using standard imaging techniques. Hepatic steatosis was diagnosed by abdominal ultrasonography. Regional myocardial hypokinesis was determined according to routine echocardiographic assessment of left ventricular wall motion and classified as either present or absent. Statistical analyses were performed using Student's t-test, the chi-square test, Spearman's rank correlation, and odds ratio estimation. Statistical significance was accepted at p<0.05.

Results: Regional myocardial hypokinesis was identified in 26 of the 60 participants (43.3%). Individuals with hypokinesis demonstrated a higher mean epicardial fat thickness than those without regional wall-motion abnormalities (8.8 ± 3.1 mm versus 7.2 ± 2.6 mm). Although this difference did not achieve statistical significance (p=0.08), correlation analysis revealed a weak positive relationship between epicardial fat thickness and myocardial hypokinesis (Spearman's r=0.29). No statistically significant association was observed between hepatic steatosis and regional myocardial hypokinesis (p=0.24). Patients whose epicardial fat thickness measured 10 mm or greater had approximately twice the likelihood of exhibiting regional myocardial hypokinesis compared with those with lower values (OR≈2.1).

Conclusion: The present pilot study suggests that greater epicardial adipose tissue thickness may be associated with impaired regional myocardial contractility, although the observed association was modest. In contrast, hepatic steatosis was not independently associated with regional myocardial hypokinesia in this cohort. These findings support the need for larger, prospective investigations to determine the clinical significance of epicardial adiposity as a marker of myocardial dysfunction and to clarify the biological mechanisms linking visceral fat accumulation with alterations in cardiac function.

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