Division of Cardiovascular Medicine, Department of Medicine; Department of Quantitative Health Sciences
Cardiology | Cardiovascular Diseases
Background: Epicardial adipose tissue (EAT) has been associated with adverse left atrial (LA) remodeling and atrial fibrillation (AF) outcomes, possibly because of paracrine signaling.
Objectives: We examined factors associated with a novel measure of EAT i.e., indexed LAEAT (iLAEAT) and its prognostic significance after catheter ablation (CA) of atrial fibrillation (AF).
Methods: We performed a retrospective analysis of 274 participants with AF referred for CA. LAEAT area was measured from a single pre-ablation CT image and indexed to body surface area (BSA) to calculate iLAEAT. Clinical, echocardiographic data and 1-year AF recurrence rates after CA were compared across tertiles of iLAEAT. We performed logistic regression analysis adjusting for factors associated with AF to examine relations between iLAEAT and AF recurrence.
Results: Mean age of participants was 61 +/- 10 years, 136 (49%) were women, mean BMI was 32 +/- 9 kg/m(2) and 85 (31%) had persistent AF. Mean iLAEAT was 0.82 +/- 0.53 cm(2)/m(2). Over 12-months, 109 (40%) had AF recurrence. Participants in the highest iLAEAT tertile were older, had higher CHA2DS2VASC scores, more likely to be male, have greater LA volume, and were more likely to have persistent (vs. paroxysmal) type AF than participants in the lowest iLAEAT tertile (p for all < 0.05). In regression analyses, iLAEAT was associated with higher odds of AF recurrence (OR = 2.93; 95% CI 1.34-6.43).
Conclusions: iLAEAT can quantify LA adipose tissue burden using standard CT images. It is strongly associated with AF risk factors and outcomes, supporting the hypothesis that EAT plays a role in the pathophysiology of AF.
atrial fibrillation, cardiac CT, catheter ablation, epicardial adipose tissue, left atrial remodeling, recurrence
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Copyright © 2018 Sanghai, Sardana, Hansra, Lessard, Dahlberg, Aurigemma, Fitzgibbons and McManus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DOI of Published Version
Front Cardiovasc Med. 2018 Jun 19;5:76. doi: 10.3389/fcvm.2018.00076. eCollection 2018. Link to article on publisher's site
Frontiers in cardiovascular medicine
Sanghai, Saket R.; Sardana, Mayank; Hansra, Barinder; Lessard, Darleen M.; Dahlberg, Seth T.; Aurigemma, Gerard P.; Fitzgibbons, Timothy P.; and McManus, David D., "Indexed Left Atrial Adipose Tissue Area Is Associated With Severity of Atrial Fibrillation and Atrial Fibrillation Recurrence Among Patients Undergoing Catheter Ablation" (2018). Open Access Articles. 3507.
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