The relation between total epicardial fat volume assessed by cardiac CT and the presence of atrial fibrillation

Abstract

Abstract Background Obesity is an important risk factor for atrial fibrillation (AF). Local epicardial fat enclosed by the visceral pericardial sac has been hypothesized to exert local pathogenic effects on cardiac structures. We aimed to characterize the relationship between total epicardial fat volume assessed by noncontrast cardiac CT and AF. Methods This case control study conducted from May 2013 to December 2014 in cardiology and radiology departments of Benha University Hospitals. Fifty patients with a history of AF were taken up plus control group of 50 reference patients without history of AF. All patients underwent cardiac CT imaging to measure total epicardial fat volume (EFV), together with systemic obesity indices as body mass index (BMI), waist circumference and body weight plus echocardiographic parameters as left atrium (LA) volume index, left ventricular ejection fraction. All these were examined in relation to the presence and chronicity of AF. Results EFV was significantly associated with the presence of AF ( p values p value = 0.002). EFV was positively correlated with LA volume index ( r = +0.45, p Conclusion Epicardial fat is associated with the presence of AF and predicts chronicity. These associations are independent to systemic measures of adiposity and sensitive echocardiographic parameters as LA volume index. These findings are consistent with the hypothesis of a local pathogenic effect of epicardial fat on the arrhythmogenic substrate supporting AF.