• Diastolic function
• Echocardiography
• Epicardial Adipose Tissue
• Hypertension
• Hypertrophy
• Inflammation
• Left ventricular remodeling

Epicardial adipose tissue (EAT) is increasingly recognized as a contributor to cardiovascular diseases, as evidenced by a large volume of studies worldwide. The prevailing hypothesis suggests that increased adiposity may play a pathogenic role through both local and systemic inflammatory mechanisms. This study investigated the association between EAT thickness and echocardiographic parameters of left ventricular (LV) morpho-functional remodeling in hypertensive patients. 300 individuals were enrolled in this study, correlation analysis between EAT and echocardiographic variables was performed using Pearson’s correlation coefficient, and variables showing significant positive correlations were further evaluated using univariate regression analysis to evaluate their predictive value and better understand the contribution of EAT to left ventricular remodeling. Patients were then stratified by systolic blood pressure (SBP) tertiles and grouped by EAT thickness (<5 mm vs. ≥5 mm). Echocardiographic assessments included interventricular septal (IVS) thickness, A-wave velocity, and early diastolic mitral annular velocity (e′). Patients with higher EAT in the top SBP tertile showed significantly increased A-wave velocity (p = 0.036), suggesting impaired LV compliance and enhanced atrial contribution to diastolic filling. e′ velocity decreased with increasing EAT, indicating subclinical diastolic dysfunction, although without statistical significance. IVS thickness showed a trend toward increase with higher EAT and SBP, but differences were not significant. These findings suggest that increased
EAT is likely associated with early diastolic functional impairment, particularly in patients with elevated SBP. EAT may represent a useful marker of subclinical LV dysfunction in hypertensive patients. Considering that EAT is a modifiable risk factor and a potential target for therapy, further research is required to clarify its prognostic significance in hypertensive individuals.