Relationship Of Thickness Of Left Atrial Epicardial Adipose Tissue And Atrial Fibrillation

Purpose: The present study confirmed that atrial fibrillation (AF) has been linkedto inflammatory factors and obesity. Atrial tissue local inflammation and cardiacautonomic nervous system has been associated with AF. Epicardial adipose tissue is aunique fat deposit in close anatomic proximity to cardiac structures and autonomicfibers, it is a source of several inflammatory mediators, which contains abundantautonomic nerve. We hypothesized that epicardial adipose tissue is related to thegenesis of AF. This study is aimed to investigate the relationship of thickness of leftatrial epicardial adipose tissue and AF.Methods:150consecutive hospitalized patients with AF from the January2008toJanuary2009underwent16-slice spiral CT(pulmonary vein CT) as the experimentalgroup,48(32%)patients with persistent AF,102(68%) patients with paroxysmal AF.131cases of non-AF patients in our outpatient for16-slice spiral spiral CT (coronaryCT) as a control group. Data retrospectively collected from patient included age, sex,body mass index (BMI)(kg/m2), comorbidities (hypertension, diabetes mellitus). TheCT dataset was processed at GE AW4.2workstation, use Cardial IQ software for3Dreconstruction. We first reconstructed standard2-and4-chamber views. The short-axisview was reconstructed as a plane perpendicular to the long axis of these2views at thelevel of the mid LA. In this short-axis view, the periatrial epicardial adipose tissuethickness was measured as the shortest distance between the mid left atrium (LA) walland3anatomic landmarks: esophagus (LA-ESO), main pulmonary artery (LA-PA), anddescending thoracic aorta (LA-TA). Axial plane measurement of the anteroposteriordiameter, sagittal measurement of the vertical diameter were performed as the LAdiameter. Results: Left atrial epicardial adipose tissue thickness in patients with persistentAF increased than that in patients with paroxysmal AF and without AF. Epicardialadipose tissue thickness in patients with AF increased than that in patients with non-AFpatients(all P value less than0.05). Epicardial adipose tissue thickness in patients withpersistent AF increased than that in patients with paroxysmal AF (all P value less than0.05). LA size and sex has significant relationships with new one AF(P value less than0.05). LA size has significant relationships with AF burden (P value less than0.05).Adjusted for age, sex, hypertension, diabetes, BMI and LA size, left atrial epicardialadipose tissue thickness had relationship with AF history duration and AF burden.Through the analysis of ROC curve, LA-ESO fat were sensitive predictive of AFburden(Under the curve area is0.798, P＜0.001,95%CI:0.733-0.863).Conclusions: Left atrial epicardial adipose tissue thickness was sensitiveassociated with AF duration and AF burden even after adjustment for BMI and LA size.Left atrial epicardial adipose tissue especially LA-ESO fat were sensitive predictive ofAF burden. Further studies are necessary to examine cause and effect, and ifinflammatory, paracrine mediators explain this association.