Epicardial adipose tissue and its association with atrial fibrillation in middle-aged patients without overt heart disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Obesity and atrial fibrillation (AF) are emerging health problem, associated with significant morbidity and mortality. There is a significant relation between body mass index (BMI) on one hand and the amount of visceral fat and epicardial adipose tissue (EAT) on the other (1,2). EAT volume is positively related to the incidence, duration, and recurrence of AF (2,3). Aim The aim of the study was to assess echocardiographic variables and their association with BMI and EAT in middle-aged patients with AF. Methods Prospective consecutive patients with AF (n= 936), who had been admitted for sinus rhythm restoration in our hospital for the period January 2016- December 2018, were screened for participation in the study. A total of 70 patients met the inclusion criteria- stable sinus rhythm, age between 40–60 years, without over heart disease. They were separated in two groups: with new onset AF (n=33) and recurrent episode of AF(n=37); 30 healthy subjects were enrolled in the control group. All patients underwent 2DE assessment with speckle tracking analyses. EAT thickness was measured perpendicularly on the free wall of the right ventricle at end-systole when both walls collapse and allow the widest measurement. Results There were significant differences in global longitudinal strain (GLS) of left ventricle (LV) and EAT between AF groups and healthy controls, but not in the other LV parameters. There were significant differences in left atrial (LA) structural and functional indices in AF groups in comparison to healthy controls- picture 1. There were significant correlations between BMI and EAT ( p = 0.001;r=0,710), GLS ( p = 0.001;r=0,557), LA volume index ( p = 0.001;r=0,701), LA reservoir strain ( p = 0.001;r=-0,626), LA stiffness index ( p = 0.001;r=0,557)- picture 2 .There were significant correlations between EAT and GLS ( p = 0.001;r=0,478), LA volume index ( p = 0.001;r=0,539), LA reservoir strain (p = 0.001;r=-0,479),LA stiffness index ( p = 0.001;r=0,487). Conclusion Epicardial adipose tissue, assessed by 2DE, was increased in middle-aged patients with obesity and AF. Obesity is significant risk factor for LA remodelling and AF, but further prospective investigation need to define the causality role of EAT in AF initiation and progression.