Skip to main content
SpringerLink
Log in

Association of epicardial and peri-atrial adiposity with the presence and severity of non-valvular atrial fibrillation

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Epicardial adipose tissue (EAT), as an endocrine organ, may serve as a source of pro-inflammatory cytokines. Also, given the strong relationship between atrial fibrillation (AF), obesity and inflammation, the purpose of this study was to investigate the association of non-valvular AF with epicardial and periatrial fat. A total of 618 (192 in sinus rhythm, 169 with paroxysmal AF, 133 with persistent AF and 124 with permanent AF) patients who underwent CT angiography for the evaluation of CAD or pulmonary vein anatomy before catheter ablation were enrolled in this study. Thickness of the EAT and periatrial fat were measured by CT angiography. Together with body mass index, these were examined in relation to the presence and severity of AF and left atrial (LA) diameter. Patients with AF had significantly more total EAT and periatrial fat thickness compared with patients in sinus rhythm (p < 0.001). EAT thickness was significantly higher in permanent, persistent and paroxysmal AF compared with sinus rhythm group (p < 0.001). Multivariable multinomial logistic regression analysis comparing patients with sinus rhythm and subtypes of AF revealed a significant association between periatrial fat and total EAT thickness with all AF subtypes. Correlation analysis demonstrated that both total EAT thickness and periatrial fat thickness were significantly correlated with LA diameter (p < 0.05). Epicardial fat thickness is associated with both the presence and severity of AF independent of all other risk factors including LA diameter. Mediators for the association of EAT with AF pathophysiology requires future large scale prospective studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. January CT, Wann LS, Alpert JS et al. (2014) 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol

  2. European Heart Rhythm A, European Association for Cardio-Thoracic S, Camm AJ et al (2010) Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the european society of cardiology (ESC). Eur Heart J 31:2369–2429

    Article  Google Scholar 

  3. Lin YK, Chen YJ, Chen SA (2011) Potential atrial arrhythmogenicity of adipocytes: implications for the genesis of atrial fibrillation. Med Hypotheses 74:1026–1029

    Article  Google Scholar 

  4. Friedrichs K, Klinke A, Baldus S (2011) Inflammatory pathways underlying atrial fibrillation. Trends Mol Med 17:556–563

    Article  CAS  PubMed  Google Scholar 

  5. Mazurek T, Zhang L, Zalewski A et al (2003) Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 108:2460–2466

    Article  PubMed  Google Scholar 

  6. Rosito GA, Massaro JM, Hoffmann U et al (2008) Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors, and vascular calcification in a community-based sample: the framingham heart study. Circulation 117:605–613

    Article  PubMed  Google Scholar 

  7. Al Chekakie MO, Welles CC, Metoyer R et al (2010) Pericardial fat is independently associated with human atrial fibrillation. J Am Coll Cardiol 56:784–788

    Article  PubMed  Google Scholar 

  8. Batal O, Schoenhagen P, Shao M et al (2010) Left atrial epicardial adiposity and atrial fibrillation. Circ Arrhythm Electrophysiol 3:230–236

    Article  PubMed Central  PubMed  Google Scholar 

  9. Wong CX, Abed HS, Molaee P et al (2011) Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol 57:1745–1751

    Article  PubMed  Google Scholar 

  10. Nagashima K, Okumura Y, Watanabe I et al (2012) Does location of epicardial adipose tissue correspond to endocardial high dominant frequency or complex fractionated atrial electrogram sites during atrial fibrillation? Circ Arrhythm Electrophysiol 5:676–683

    Article  PubMed  Google Scholar 

  11. Greif M, Von Ziegler F, Wakili R et al (2013) Increased pericardial adipose tissue is correlated with atrial fibrillation and left atrial dilatation. Clin Res Cardiol 102:555–562

    Article  CAS  PubMed  Google Scholar 

  12. Nakanishi K, Fukuda S, Tanaka A et al (2012) Peri-atrial epicardial adipose tissue is associated with new-onset nonvalvular atrial fibrillation. Circ J 76:2748–2754

    Article  CAS  PubMed  Google Scholar 

  13. Austen WG, Edwards JE, Frye RL et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40

    Article  CAS  PubMed  Google Scholar 

  14. Girerd N, Scridon A, Bessiere F et al (2013) Periatrial epicardial fat is associated with markers of endothelial dysfunction in patients with atrial fibrillation. PLoS One 8:e77167

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Thanassoulis G, Massaro JM, O'Donnell CJ et al (2010) Pericardial fat is associated with prevalent atrial fibrillation: the framingham heart study. Circ Arrhythm Electrophysiol 3:345–350

  16. Tsao HM, Hu WC, Wu MH et al (2011) Quantitative analysis of quantity and distribution of epicardial adipose tissue surrounding the left atrium in patients with atrial fibrillation and effect of recurrence after ablation. Am J Cardiol 107:1498–1503

    Article  PubMed  Google Scholar 

  17. Shinohara T, Shen MJ, Han S et al (2012) Heart failure decreases nerve activity in the right atrial ganglionated plexus. J Cardiovasc Electrophysiol 23:404–412

  18. Shin SY, Yong HS, Lim HE et al (2011) Total and interatrial epicardial adipose tissues are independently associated with left atrial remodeling in patients with atrial fibrillation. J Cardiovasc Electrophysiol 22:647–655

    Article  PubMed  Google Scholar 

  19. Kanazawa H, Yamabe H, Enomoto K et al (2014) Importance of pericardial fat in the formation of complex fractionated atrial electrogram region in atrial fibrillation. Int J Cardiol 174:557–564

  20. Yorgun H, Canpolat U, Hazirolan T et al (2012) Epicardial adipose tissue thickness predicts descending thoracic aorta atherosclerosis shown by multidetector computed tomography. Int J Cardiovasc Imaging 28:911–919

Download references

Conflict of interest

Authors of this study do not have any conflict of interest.

Author information

Authors and Affiliations

  1. Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Hikmet Yorgun, Kudret Aytemir, Levent Şahiner, Ergün Barış Kaya, Giray Kabakci, Lale Tokgözoğlu, Necla Özer & Ali Oto

  2. Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, 06100, Ankara, Turkey

    Uğur Canpolat

  3. Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Tuncay Hazırolan

Authors
  1. Hikmet Yorgun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Uğur Canpolat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kudret Aytemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tuncay Hazırolan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Levent Şahiner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ergün Barış Kaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giray Kabakci
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Lale Tokgözoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Necla Özer
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ali Oto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Uğur Canpolat.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yorgun, H., Canpolat, U., Aytemir, K. et al. Association of epicardial and peri-atrial adiposity with the presence and severity of non-valvular atrial fibrillation. Int J Cardiovasc Imaging 31, 649–657 (2015). https://doi.org/10.1007/s10554-014-0579-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-014-0579-5

Keywords

Search

Navigation