Elevated epicardial fat thickness and plasma free fatty acid are associated with ischemic stroke with atrial fibrillation

Abstract

Recently, a relationship between the thickness of epicardial adipose tissue and the incidence and severity of atrial fibrillation (AF) has been reported. However, the potential association between epicardial fat thickness (EFT) and plasma free fatty acid (FFA) level in ischemic stroke with or without AF has not been previously investigated. The objective of this study was to assess the performance of EFT and plasma FFA level in identifying patients with ischemic stroke and AF. We retrospectively included 214 patients (mean age, 66.8 ± 12.3 years; 39.7% women) with acute ischemic stroke who were admitted within 3 days of symptom onset to a single university hospital. EFT was measured perpendicular from the free wall of the right ventricle at end-systole in three cardiac cycles. The ischemic stroke with AF group showed significantly higher plasma FFA level (1,379.7 ± 717.5 vs. 757.8 ± 520.5 uEq/L, p<0.001) and EFT (6.5 ± 1.2 vs. 5.3 ± 1.2 mm, p < 0.001) and poorer prognosis than the group without AF. In addition, plasma FFA level was significantly correlated with EFT and plasma FFA level and EFT were independently associated with stroke with AF. According to the final model, which was selected in stepwise fashion, both EFT (adjusted odds ratio [OR], 2.031; 95% confidence interval [CI], 1.454-2.938; p < 0.001) and FFA (adjusted OR, 1.002; 95% CI, 1.001-1.002; p < 0.001) were independent predictor factors associated with ischemic stroke with AF after adjusting for age. Echocardiographic EFT and plasma FFA levels could facilitate the identification of patients with ischemic stroke with AF.