The purpose of this study was to examine the association between epicardial fat thickness measured by echocardiography and myocardial fat determined by magnetic resonance. A group of twenty Caucasian men (body mass index 30.5±2 kg/m2, 42±7 years of age) who were referred for cardiometabolic risk assessment were analyzed in this study. An independent and strong relation was observed between echocardiographically assessed epicardial fat thickness and myocardial fat. Multivariate analysis revealed that epicardial fat thickness was the best predictor of myocardial fat among waist circumference and other traditional risk factors. The authors also found that plasma adiponectin levels were inversely related to myocardial lipid content. These results support the use of echocardiography to quantify epicardial fat thickness as a marker of myocardial fat.