Epicardial adipose tissue and nonvalvular atrial fibrillation

Abstract Background Several studies revealed the relationship between epicardial fat tissue (EF) and development of atrial fibrillation (AF). Though pathophysiological mechanisms are not clear enough, the anatomy and location EF as a part of visceral adiposity tissue could lead to proinflammatory and fibrotic changes in atrial myocardium. Purpose To evaluate the paracrine effects of EF and detect the association of tissue Doppler imaging (TDI) parameters, EF thickness by cardiac magnetic resonance tomography (CMR) and biochemical markers of fibrosis and inflammation in patients with nonvalvular AF without concomitant coronary artery disease. Methods Thirty-nine patients with idiopathic paroxysmal AF, normal or slightly enlarged left atria (LA) (mean LA diameter 4,5±0,6cm) were included. The mean age was 50,8±13,9 y.o., 19 (49%) were men. The absence of coronary lesions was confirmed by angiography in all cases. Besides standard ECG and ECHO, all patients underwent TDI and CMR with late gadolinium enhancement. EP thickness at anterior left ventricular (LV) wall was estimated by CMR. The myocardial fibrotic and proinflammatory biomarkers levels - matrix metalloproteinases (MMP-2, MMP-9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were estimated. Kendall rank correlation coefficient was used. If the |τ| >Tcr, the correlation ranked as statistically significant. Results The epicardial fat thickness was associated with TIMP-1 plasma level (τ=0,71; Tcr=0,18) and MMP-9 (τ=0,65; Tcr=0,16). Among clinical factors weight was slightly associated with fat thickness (τ=0,33; Tcr=0,26). Besides, we found correlation of MMP-9, TIMP-1 with E/e' by TDI (τ=0,65; Tcr=0,16 and τ=0,56; Tcr=0,21, relatively); and with maximal systolic strain of lateral LV wall (τ=−0,37; Tcr=0,18 and τ=−0,44; Tcr=0,16, relatively) and interventricular septum (τ=−0,36; Tcr=0,18 and τ=−0,44; Tcr=0,16, relatively). Conclusion The epicardial fat thickness by CMR is significantly associated with myocardial fibrosis markers (MMP-9, TIMP-1) in patients with AF without structural heart disease. The increasing levels of MMP-9 and TIMP-1 are associated with LV local contractility disturbances by TDI in patients with AF. This association demonstrates the paracrine effect of EF, which could lead to atrial remodeling and formation AF substrate even in patients without valvular and ischemic heart disease and with normal or slightly enlarged LA FUNDunding Acknowledgement Type of funding sources: None.

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Epicardial fat thickness in infants of diabetic mothers

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-210787 ◽

2021 ◽

pp. 1-6

Author(s):

M.M. Vela-Huerta ◽

N. Amador-Licona ◽

R. Domínguez-Damiá ◽

A. Heredia-Ruiz ◽

H.V. Orozco-Villagomez ◽

...

Keyword(s):

Interventricular Septum ◽

Left Ventricular ◽

Epicardial Fat ◽

Left Ventricular Ejection ◽

Epicardial Fat Thickness ◽

Infants Of Diabetic Mothers ◽

Significant Difference ◽

Echocardiographic Parameters ◽

Fat Thickness ◽

Diabetic Mothers

BACKGROUND: Epicardial fat thickness (EFT) in adults and children has been related to the metabolic syndrome and other cardiovascular risk factors; however, scarce studies have evaluated it in infants of diabetic mothers (IDM) in whom, alterations in the thickness of the interventricular septum have been reported. This study compares the EFT in IDM versus infants of non-diabetic mothers (INDM) and its association with others echocardiographic parameters. METHODS: We performed a cross sectional study in 93 infants (64 IDM and 29 INDM). To evaluate EFT dimensions, an echocardiogram was performed within the first 24h of extrauterine life in both groups. In diabetic mothers, HbA1c was also determined. RESULTS: There was no significant difference in birth weight between the groups although gestational age was lower in IDM. The EFT (3.6 vs. 2.5 mm, p < 0.0001), the interventricular septum thickness (IVST) (6.2 vs. 5.2 mm, p < 0.0001) and the IVST / left ventricle posterior wall (1.3 vs. 1.1, p = 0.001) were higher in the IDM; while the left ventricular expulsion fraction [LVFE] (71.1 vs. 77.8; p < 0.0001) was lower than in the INDM, respectively. We found a positive correlation between EFT with IVST (r = 0.577; p = 0.0001), LVPW (r = 0.262; p = 0.011), IVST/LVPW index (r = 0.353; p = 0.001), and mitral integral early velocity (r = 0.313; p = 0.002), while a negative correlation with LVFE was observed (r = –0.376; p = 0.0001). CONCLUSIONS: The EFT is higher in IDM than in INDM. It was positively related with echocardiographic parameters of left ventricular thickness and negatively with left ventricular ejection function.

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Abstract 3068: Intra-left Ventricular Contractile Dyssynchrony As An Independent Determinant Of Left Atrial Remodeling In Patients With Atrial Fibrillation Managed by Catheter-based Circumferential Pulmonary Venous Isolation

Circulation ◽

10.1161/circ.116.suppl_16.ii_688 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

FU-CHUN CHIU ◽

Yi-Chih Wang ◽

Chih-Chieh Yu ◽

Ling-Ping Lai ◽

Juey-Jen Hwang ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Catheter Ablation ◽

Sinus Rhythm ◽

Left Atrial ◽

Left Ventricular ◽

Filling Pressure ◽

Doppler Imaging ◽

Atrial Remodeling ◽

Independent Determinant

BACKGROUND. Enlarged left atrial volume (LAV), resulting from multifactorial pathogenesis, carries a poorer prognosis to patients with atrial fibrillation (AF) even under well rhythm control. We hypothesized that the preexistence of intra-left ventricular (LV) contractile dyssynchrony impaired diastolic filling, which contribute to atrial remodeling in AF patients. METHODS. We investigated 40 patients (34 men and 6 women, mean age 60 ± 10 years) with paroxysmal or persistent AF who were converted mainly by catheter ablation-based circumferential pulmonary venous isolation and then pharmacologically maintained in sinus rhythm. Exclusion criteria included significant (>moderate) valvular heart disease, LV ejection fraction <55 %, or ischemic heart disease confirmed by positive stress tests or coronary angiography. The LAV was measured by 2D echocardiography [π×D1×D2×D3/6 from parasternal long-axis view (D1) and apical four-chamber view (D2 & D3)]. The peak myocardial systolic velocity (S M ) and the time to peak S M (T S ) of the 6-basal and 6-mid LV segments were measured by tissue Doppler imaging (TDI). RESULTS. With similar AF duration before conversion, patients with LAV >40ml (n = 16) had similar baseline characteristics, cardiovascular medications, QRS width, and LV chamber sizes as those with LAV <40ml (n = 24). However, TDI showed the mean S M was borderline lower (6.3 ± 1.2 vs. 7.1 ± 1.2 cm/s, p < 0.05), and the maximal intersegmental difference in T S (77 ± 43 vs. 40 ± 22 ms, p < 0.003) was greater in patients with larger LAV. The intersegmental difference in T S correlated positively with LAV (r = 0.41, p < 0.009), and LV filling pressure estimated by early transmitral flow velocity/annular diastolic velocity was significantly higher (12.3 ± 7.8 vs. 8.7 ± 2.2, p < 0.045) in patients with intersegmental difference in T S >65 ms. After adjusting for age, gender, and the diastolic parameters, intersegmental difference in T S >65ms emerged as an independent determinant of larger LAV in multivariate logistic analysis (OR=17; 95% CI=2–166, p < 0.016). CONCLUSIONS. Intraventricular dyssynchrony, which accompanied with elevated LV filling pressure, contributed independently to LA remodeling in AF patients converted into sinus rhythm by catheter ablation.

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PP-066 RELATIONSHIP BETWEEN EPICARDIAL FAT THICKNESS AND LEFT VENTRICULAR SYNCHRONICITY IN PATIENTS WITHOUT STRUCTURAL HEART DISEASE

International Journal of Cardiology ◽

10.1016/s0167-5273(13)70270-5 ◽

2013 ◽

Vol 163 (3) ◽

pp. S107

Author(s):

A. Kırış ◽

G. Kırış ◽

O.E. Turan ◽

M. Öztürk ◽

M. Şahin ◽

...

Keyword(s):

Heart Disease ◽

Structural Heart Disease ◽

Left Ventricular ◽

Epicardial Fat ◽

Epicardial Fat Thickness ◽

Fat Thickness

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Relationship between the epicardial fat thickness and total atrial conduction time in patients with lone paroxysmal atrial fibrillation

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.03.091 ◽

2015 ◽

Vol 185 ◽

pp. 106-108 ◽

Cited By ~ 2

Author(s):

Uğur Canpolat ◽

Kudret Aytemir ◽

Necla Özer ◽

Ali Oto

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Epicardial Fat ◽

Conduction Time ◽

Epicardial Fat Thickness ◽

Atrial Conduction Time ◽

Fat Thickness

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Epicardial fat thickness: A new predictor of successful electrical cardioversion and atrial fibrillation recurrence

Echocardiography ◽

10.1111/echo.14178 ◽

2018 ◽

Vol 35 (12) ◽

pp. 1926-1931 ◽

Cited By ~ 8

Author(s):

Seçkin Dereli ◽

Adil Bayramoğlu ◽

Osman Can Yontar ◽

Sinan Cerşit ◽

Mustafa Ozan Gürsoy

Keyword(s):

Atrial Fibrillation ◽

Electrical Cardioversion ◽

Epicardial Fat ◽

Atrial Fibrillation Recurrence ◽

Epicardial Fat Thickness ◽

Fat Thickness

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Abstract WP233: Epicardial Fat Thickness, Free Fatty Acid and Pro-BNP Predict Atrial Fibrillation in Acute Ischemic Stroke

Stroke ◽

10.1161/str.48.suppl_1.wp233 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Jin-Hyung Lee ◽

Meyung-Kug Kim ◽

Bong-Goo Yoo

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Fatty Acid ◽

Free Fatty Acid ◽

Acute Ischemic Stroke ◽

Epicardial Fat ◽

Epicardial Fat Thickness ◽

Fat Thickness ◽

Hs Crp ◽

D Dimer

Background/Objectives: Detection of atrial fibrillation (AF) is important for diagnosis of cardioembolic stroke. Few studies that cardioembolic stroke relate to some biomarkers such as high sensitive C-reactive protein (hs-CRP), free fatty acid (FFA), pro-brain natriuretic peptide (pro-BNP) and D-dimer have been reported. FFAs are major components of epicardial fat. Increased epicardial fat thickness (EFT) is known to be associated with the presence of AF. The object of this study is to find the useful markers to distinguish stroke with AF in acute ischemic stroke. Design/Method: Total 214 consecutive patients (mean age, 66.8±12.3 years; 39.7% women; 16.4% AF group) with acute ischemic stroke within 72 hours of onset were retrospectively enrolled. We analyzed the EFT and the several biomarkers between stroke with and without AF. Results: Age, heart rate, FFA, pro-BNP, hs-CRP, HDL and the frequency of woman were significantly higher in AF group (p <0.05). Estimated glomerular filtration rate (eGFR) was significantly lower in AF group (p<0.05). D-dimer and myoglobin were no significant difference. EFT (6.45±1.18 vs 5.30±1.23 mm, p<0.001), Left atrium (LA) diameter and LA volume were significantly higher in AF group. The respective cut-off value of EFT, FFA and pro-BNP for prediction of the AF were 5.58mm, 1226.5 μEq/ml and 295.0 pg/ml (sensitivity 85%, specificity 61%, AUC 0.76 for EFT; 67%, 93%, 0.79 for FFA; 82%, 84%, 0.88 for pro-BNP). Multivariate logistic regression analysis demonstrated that age, FFA and EFT were independently associated with the presence of AF (p<0.05). Conclusions: The combination of EFT, FFA and pro-BNP can be a useful marker for the prediction of the AF in acute ischemic stroke.

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The Impact of Echocardiographic Epicardial Fat Thickness on Outcomes of Cryoballoon-Based Atrial Fibrillation Ablation

Echocardiography ◽

10.1111/echo.13193 ◽

2016 ◽

Vol 33 (6) ◽

pp. 821-829 ◽

Cited By ~ 11

Author(s):

Uğur Canpolat ◽

Kudret Aytemir ◽

Hikmet Yorgun ◽

Serkan Asil ◽

Muhammed Dural ◽

...

Keyword(s):

Atrial Fibrillation ◽

Atrial Fibrillation Ablation ◽

Epicardial Fat ◽

Epicardial Fat Thickness ◽

Fat Thickness ◽

The Impact

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Epicardial fat thickness, an emerging cardiometabolic risk factor, is increased in young adults born preterm

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174416000234 ◽

2016 ◽

Vol 7 (4) ◽

pp. 369-373 ◽

Cited By ~ 7

Author(s):

P. P. Bassareo ◽

V. Fanos ◽

M. Puddu ◽

S. Marras ◽

G. Mercuro

Keyword(s):

Birth Weight ◽

Left Ventricular Mass ◽

Gestational Age ◽

Cardiovascular Events ◽

Left Ventricular ◽

Extremely Low Birth Weight ◽

Epicardial Fat ◽

Epicardial Fat Thickness ◽

Ventricular Mass ◽

Fat Thickness

Preterm birth and epicardial fat thickness (EFT) constitute novel risk factors for the onset of future adverse cardiovascular events. In total, 30 ex-extremely low birth weight (ex-ELBW) subjects (10 males, 20 females, aged 17–28) were enrolled and compared with 30 healthy peers. EFT was significantly higher (8.7±0.7 mm v. 5.6±0.9 mm; P<0.001) in ex-ELBW than in controls and was correlated with birth weight (r=−0.47, P=0.0009), gestational age (r=−0.39, P=0.03) and cardiac left ventricular mass (r=0.51, P=0.004). When excluding the influence of body mass index, birth weight was the sole remaining determinant of EFT, irrespective of gestational age (r=−0.37, P=0.04). The same findings when excluding the possible influence of blood pressure values on the cardiac structures (r=−0.40, P=0.028). In conclusion, EFT is significantly higher in former preterm subjects and is likewise associated with an increase in left ventricular mass. In view of the acknowledged correlation between the latter and an increased incidence of cardiovascular diseases, EFT appears to be an easy-to-measure tool capable of predicting the likely development of future adverse cardiovascular events in these subjects.

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