The correlation of epicardial adipose tissue thickness and atrial fibrillation by echocardiography

Abstract

Objective To investigate the association between atrial fibrillation (AF) and epicardial adipose tissue (EAT) by echocardiography. Methods One hundred and thirty-eight patients of AF in First Affiliated Hospital of Chinese People′s Liberation Army General Hospital from March 2014 to June 2016 were divided into two groups, including paroxysmal AF group with 87 casesand persistent AF group with 51 cases, and 112 cases of sinus rhythm were chosen as control group. Epicardial adipose tissue was measured using echocardiography in all patients, and the conventional parameters were recorded. One-way analysis of variance was used to compare the thickness of EAT in patients with paroxysmal AF group, persistent AF group and sinus rhythm group, and LSD-t test was used in further comparison between two groups. Multivariable logistic regression analysis was used to analyze the risk factors of AF. The receiver-operating characteristic (ROC) cure of EAT and left atrium diameter (LAD) were drawn to predict the incidence of AF. The correlation between EAT thickness and LAD was analyzed by Pearson correlation analysis. Results The thickness of EAT in patients with persistent AF, paroxysmal AF and sinus rhythm group were (4.75±1.83), (4.32±1.76) and (1.38±0.68) mm, respectively. Epicardial adipose tissue was significantly larger in paroxysmal AF and persistent AF patients compared with that of sinus rhythm group, and the differences were statistically significant (t=-9.541, -11.439, both P<0.01). Logistic regression analysis indicated that EAT thickness and LAD were independent risk factors of atrial fibrillation (odds ratio: 3.17, 95% confidence interval: 1.31-7.68, P<0.01; odds ratio: 2.65, 95% confidence interval 1.69-4.15, P<0.05). The area under the curve (AUC) of EAT and LAD to predict presence of AF were 0.784 and 0.865, and the best threshold value were 4.45 mm and 40.00 mm, respectively. Pearson correlation analysis showed that the EAT thickness and LAD had significantly positive correlation (r=0.512, P<0.01). Conclusions The increase of EAT thickness is significantly correlated with the incidence of AF and is independent to traditional risk factors. Therefore, the increase of EAT thickness has certain clinical value to predict AF. Key words: Epicardial adipose tissue; Atrial fibrillation; Echocardiography