Aim:
To study the relationship between epicardial and visceral obesity with the nature of the disease and cardiac remodeling in patients with acquired mitral valve disease before valvular surgical correction.

Material and methods:
The study included 51 patients hospitalized for correction of acquired mitral valve disease of non-infectious genesis. Patients were divided into groups according to multispiral computed tomography data before the surgery: with visceral obesity (group 1: visceral adipose tissue 130 cm2 (n = 28)), and a group without visceral obesity (group 2; n = 21).

Results:
In the group of patients with visceral obesity, there was a more pronounced violation of the global longitudinal strain of the left ventricle compared to the group without visceral obesity (-15,65 [-18,8; -11,6] % vs -19.4 [-21,3; -16,9] %, p=0,0198). The ejection fraction of the right ventricle (3D Echo) in group 1 was lower compared to patients in group 2: Me 46 [40,6; 48,9] vs 53 [45,8; 54,2] %, (p=0,0419). It was revealed that an increase in the volume of epicardial adipose tissue by 1 cm3 according to multispiral computed tomography data is associated with an increase in the left atrium by a B-coefficient of 0,009 (p=0,0001), the end-systolic volume of the left ventricle by a B-coefficient of 0,1224, p=0,0456). The visceral adipose tissue/subcutaneous adipose tissue index >0,4 is associated with an increase in the left ventricular myocardial mass index by a B-coefficient of 44,7 (p=0,0002), the end-diastolic and systolic sizes of the left ventricle by a B-coefficient of 0,7 (p=0,0168) and a B-coefficient of 0,4957 (p=0,0121), respectively. According to ROC analysis, the volume of epicardial adipose tissue >115,1 cm3 is associated with the presence of cardiac rhythm disorders such as atrial fibrillation/flutter (AUC=0,714, p=0,003).

Conclusion:
The presence of visceral obesity, including epicardial obesity, is associated with more pronounced structural and functional disorders of the left and right ventricles in patients with acquired MV disease.