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Yakup Yiğit

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Open access Aug 2026

Epicardial Fat Thickness and Nighttime Systolic Blood Pressure Variability in Healthy Young Adults

We recognise epicardial fat thickness (EFT) as a biomarker for cardiometabolic risk and blood pressure variability (BPV) as an independent risk factor for cardiovascular morbidity. While studies link them in hypertensive patients, data for healthy young adults are lacking. This study examines the relationship between EFT-BPV in healthy young adults. Demonstrating this relationship in healthy young adults may be important for the early identification of individuals at higher cardiovascular risk and could inform strategies to reduce future cardiovascular events. This study included 172 apparently healthy young adults (18–41 years old) presenting with atypical chest pain but without known chronic disease or abnormal cardiac findings. EFT was measured via transthoracic echocardiography, and a 24-hour Ambulatory blood pressure monitoring (ABPM) was used to assess BPV. Laboratory tests, body mass index (BMI), and fatty liver index (FLI) were evaluated. Correlations and regression analyses were used to explore associations; significance was set at p < 0.05. Power analysis confirmed an adequate sample size (N = 170, f²=0.15, α = 0.05, power = 0.80). EFT was significantly correlated with 24-hour systolic BPV (r = 0.171, p = 0.028), 24-hour diastolic BPV (r = 0.173, p = 0.025), nighttime systolic BPV (r = 0.193, p = 0.012), and nighttime diastolic BPV (r = 0.183, p = 0.018). In multivariable regression analysis, EFT, smoking, and platelet/basophil ratio were independently associated with nighttime systolic BPV (R² = 0.110, p = 0.002). These findings demonstrate an association between EFT and BPV in apparently healthy young adults, with the strongest association observed for nighttime systolic BPV. Longitudinal studies are needed to clarify directionality and causality. Proposed Mechanisms Underlying the Association Between Epicardial Fat Thickness and Nighttime Systolic Blood Pressure Variability. Based on literature, a schematic illustrating proposed mechanisms that may underlie the association between EFT and nighttime systolic BPV in healthy young adults. EFT may be associated with increased BPV through inflammatory pathways and sympathetic overactivity. Abbreviations: EFT epicardial fat thickness, BPV blood pressure variability Proposed Mechanisms Underlying the Association Between Epicardial Fat Thickness and Nighttime Systolic Blood Pressure Variability. Based on literature, a schematic illustrating proposed mechanisms that may underlie the association between EFT and nighttime systolic BPV in healthy young adults. EFT may be associated with increased BPV through inflammatory pathways and sympathetic overactivity. Abbreviations: EFT epicardial fat thickness, BPV blood pressure variability

Güney Sarıoğlu, Yakup Yiğit · Artery Research · 0 citations

Open access Jul 2026

Electro-Mechanical Cardiac Remodeling in Metabolic Syndrome: Association Between Frontal QRS-T Angle and Subclinical Left Ventricular Dysfunction Assessed by Four-Dimensional Echocardiography

Background/Objectives: Metabolic syndrome (MS) has been demonstrated to be associated with subclinical myocardial dysfunction, which develops in the early stages. It has been hypothesised that traditional echocardiographic parameters may be insufficient in detecting these changes. The frontal QRS-T angle is an electrocardiographic parameter that is easily obtained and that reflects ventricular electrical heterogeneity. This study aimed to examine the relationship between the frontal QRS–T angle and left ventricular myocardial deformation, as assessed by four-dimensional strain echocardiography (4DSE), in patients with MS. Methods: The present cross-sectional study comprised 70 patients diagnosed with MS and 61 healthy individuals matched for age and gender. All participants underwent standard transthoracic and 4DSE examination and 12-lead electrocardiography. The values of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) and global area strain (GAS) were analysed. The frontal QRS-T angle was calculated as the absolute difference between the QRS and T axes. The interrelationships between the variables were assessed using correlation and multivariate linear regression analyses. Results: Despite comparable left ventricular ejection fraction (LVEF) between the groups, 4DSE-derived myocardial deformation parameters, including GLS, GCS, GAS, and GRS, were significantly impaired in the MS group. The frontal QRS-T angle was found to be significantly higher in patients diagnosed with MS in comparison to the control group (p < 0.001). A significant correlation was identified between the frontal QRS-T angle and GLS (r = 0.498, p < 0.001). In multivariable linear regression analysis, the frontal QRS–T angle was independently associated with GLS (standardized β = 0.501, p < 0.001). In exploratory receiver operating characteristic (ROC) analysis, the frontal QRS–T angle showed moderate discriminatory ability for GLS-defined impaired myocardial deformation area under the curve (AUC) = 0.720). Conclusions: An increased frontal QRS–T angle in individuals with metabolic syndrome was independently associated with subclinical LV dysfunction despite preserved ejection fraction (EF). These findings suggest that the frontal QRS–T angle may serve as a simple and readily available electrocardiographic marker associated with impaired myocardial deformation, warranting further validation in larger prospective studies.

Z. Ulutaş, Yakup Yiğit, Miraç Karaağaç et al. · Journal of Clinical Medicine · 0 citations