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. 2024 Dec;13(1):2395565.
doi: 10.1080/21623945.2024.2395565. Epub 2024 Sep 9.

The change of epicardial adipose tissue characteristics and vulnerability for atrial fibrillation upon drastic weight loss

Eva R Meulendijks  1   2 , Carolina Janssen-Telders  2   3 , Elise L Hulsman  1 , Nick Lobe  4 , Pietro Zappala  1   2 , Marc M Terpstra  1   2 , Robin Wesselink  1   2 , Tim A C de Vries  1   2   3   5 , Rushd F Al-Shama  1   2 , Ruben N van Veen  6 , Steve M M de Castro  6 , Claire E E de Vries  6   7 , Leontien M G Nijland  6 , R Nils Planken  1   2   4 , Sebastien P J Krul  8 , Joris R de Groot  1   2
Affiliations

The change of epicardial adipose tissue characteristics and vulnerability for atrial fibrillation upon drastic weight loss

Eva R Meulendijks et al. Adipocyte. 2024 Dec.

Abstract

Background: Obesity increases the risk of atrial fibrillation (AF). We hypothesize that 'obese' epicardial adipose tissue (EAT) is, regardless of comorbidities, associated with markers of AF vulnerability.

Methods: Patients >40y of age undergoing bariatric surgery and using <2 antihypertensive drugs and no insulin were prospectively included. Study investigations were conducted before and 1y after surgery. Heart rhythm and p-wave duration were measured through ECGs and 7-d-holters. EAT-volume and attenuation were determined on non-enhanced CT scans. Serum markers were quantified by ELISA.

Results: Thirty-seven patients underwent surgery (age: 52.1 ± 5.9y; 27 women; no AF). Increased p-wave duration correlated with higher BMI, larger EAT volumes, and lower EAT attenuations (p < 0.05). Post-surgery, p-wave duration decreased from 109 ± 11 to 102 ± 11ms. Concurrently, EAT volume decreased from 132 ± 49 to 87 ± 52ml, BMI from 43.2 ± 5.2 to 28.9 ± 4.6kg/m2, and EAT attenuation increased from -76.1 ± 4.0 to -71.7 ± 4.4HU (p <0.001). Adiponectin increased from 8.7 ± 0.8 to 14.2 ± 1.0 μg/ml (p <0.001). However, decreased p-wave durations were not related to changed EAT characteristics, BMI or adiponectin.

Conclusion: In this explorative study, longer p-wave durations related to higher BMIs, larger EAT volume, and lower EAT attenuations. P-wave duration and EAT volume decreased, and EAT attenuation increased upon drastic weightloss. However, there was no relation between decreased p-wave duration and changed BMI or EAT characteristics.

Keywords: (epicardial) adipose tissue; Adipokines; adipose remodelling; atrial fibrillation; bariatric surgery.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

x-y graph of mixed model analyses: fitted linear line with all EAT attenuation and p-wave duration values from baseline (black) and follow-up (red) moments. x-y graph of mixed model analyses: fitted linear line with all EAT volume and p-wave duration values from baseline (black) and at follow-up (red) moments. x-y graph of mixed model analyses: fitted linear line with all BMI and p-wave duration values from baseline (black) and at follow-up (red) moments.
Figure 1.
Figure 1 shows the relation between p-wave duration on the x-axes and EAT characteristics and BMI on the y-axes. Analyses were performed with linear mixed models: 10 ms increase in p-wave relates to 1a: a 19.4 ml larger volume of EAT (p = 0.005), 1b: −1.7HU units lower EAT attenuation (p = 0.002), and 1c: a 2.4 kg/m2 higher BMI (p = 0.02).
x-y graph of mixed model analyses: fitted linear line with all EAT volume and adiponectin values from baseline (black) and follow-up (red) moments. x-y graph of mixed model analyses: fitted linear line with all EAT attenuation and adiponectin values from baseline (black) and follow-up (red) moments. x-y graph of mixed model analyses: fitted linear line with all BMI and adiponectin values from baseline (black) and follow-up (red) moments. x-y graph of mixed model analyses: fitted linear line with all p-wave duration and adiponectin values from baseline (black) and follow-up (red) moments.
Figure 2.
Figure 2 shows the relation between serum adiponectin on the x-axes and EAT characteristics and BMI on the y-axes. Analyses were performed with linear mixed models: 5.5 μg (5532 ng) higher serum adiponectin relates to 2a: the decrease of 27 ml of EAT (p < 0.001), 2b: the increase of 2.9HU units EAT attenuation (p < 0.001), 2c: the decrease of 4.1 kg/m2 BMI (p = 0.004), and 2d: unchanged p-wave duration (−2.0 ms, p = 0.22).
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