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. 2018 Sep 17:6:2050312118799908.
doi: 10.1177/2050312118799908. eCollection 2018.

Opposite relations of epicardial adipose tissue to left atrial size in paroxysmal and permanent atrial fibrillation

Stavroula N Psychari  1 , Dionysios Tsoukalas  1 , Dimitrios Varvarousis  1 , Anastasios Papaspyropoulos  1 , Eleni Gkika  2 , Athanasios Kotsakis  1 , Ioannis A Paraskevaidis  3 , Efstathios K Iliodromitis  4
Affiliations

Opposite relations of epicardial adipose tissue to left atrial size in paroxysmal and permanent atrial fibrillation

Stavroula N Psychari et al. SAGE Open Med. .

Abstract

Objectives: Atrial fibrillation has been associated with obesity in epidemiological studies. Epicardial adipose tissue is an ectopic fat depot in the proximity of atria, with endocrine and inflammatory properties that is implicated in the pathophysiology of atrial fibrillation. Inflammation also has a role in atrial arrhythmogenesis. The aim of this study was to investigate the potential relations of epicardial adipose tissue to left atrial size and to adiponectin and the pro-inflammatory mediators, high-sensitivity C-reactive protein, and interleukin-6 in paroxysmal and permanent atrial fibrillation.

Methods: This was a cross-sectional study of 103 atrial fibrillation patients, divided into two subgroups of paroxysmal and permanent atrial fibrillation, and 81 controls, in sinus rhythm. Echocardiography was used for estimation of epicardial adipose tissue and left atrial size and high-sensitivity C-reactive protein, interleukin-6 and adiponectin were measured in all subjects.

Results: Atrial fibrillation patients had significantly larger epicardial adipose tissue compared with controls (0.43 ± 0.17 vs 0.34 ± 0.17 cm, p = 0.002). Atrial fibrillation presence was independently related to epicardial adipose tissue thickness (b = 0.09, p = 0.002). Opposite associations of epicardial adipose tissue with left atrial volume existed in atrial fibrillation subgroups; in the paroxysmal subgroup, epicardial adipose tissue was directly related to left atrial volume (R = 0.3, p = 0.03), but in the permanent one the relation was inverse (R = -0.7, p < 0.0001). Adiponectin, high-sensitivity C-reactive protein and interleukin-6 were elevated in both atrial fibrillation groups. Only interleukin-6 was related to epicardial adipose tissue size.

Conclusion: Opposite associations of epicardial adipose tissue with left atrial size in paroxysmal and permanent Atrial fibrillation and elevated inflammatory markers, suggest a role of epicardial adipose tissue and inflammation in the fibrotic and remodeling process.

Keywords: Epicardial fat; adiponectin; atrial fibrillation.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Echocardiographic measurement of epicardial adipose tissue (EAT) in the parasternal long axis view. The anterior echo-lucent space between the linear echo-dense visceral pericardium and the right ventricular epicardium was considered to be EAT. Pericardial fat (PERI FAT), was identified as the hypoechoic space anterior to the EAT and the parietal pericardium.
Figure 2.
Figure 2.
Differences in epicardial fat thickness among patients with paroxysmal AF, permanent AF, and sinus rhythm controls
Figure 3.
Figure 3.
Relations of epicardial fat thickness to left atrial (LA) volume in the paroxysmal and the permanent atrial fibrillation (AF) subgroups.
See this image and copyright information in PMC

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