Association Between Posterior Left Atrial Adipose Tissue Mass and Atrial Fibrillation

作者：van Rosendael Alexander R; Dimitriu Leen Aukelien C; van Rosendael Philippe J; Leung Melissa; Smit Jeff M; Saraste Antti; Knuuti Juhani; van der Geest Rob J; van der Arend Britt W H; van Zwet Erik W; Scholte Arthur J; Delgado Victoria; Bax Jeroen J

来源：Circulation-Arrhythmia and Electrophysiology, 2017, 10(2): e004614.

DOI：10.1161/CIRCEP.116.004614

• adipose tissue
• atrial fibrillation
• body mass index
• computed tomographic angiography
• left atrium

Background-Epicardial adipose tissue located close to the atrial wall can change the electric conduction of the left atrium, potentially leading to atrial fibrillation (AF). The aim of this study was to assess whether an increased atrial adipose tissue mass posterior to the left atrium is related to AF independent of demographical and cardiovascular risk factors.
Methods and Results-Two hundred patients with AF and 200 patients without AF who underwent computed tomographic angiography were included. The posterior left atrial adipose tissue mass was quantified on computed tomographic angiography images as tissue with Hounsfield Units between -195 and -45. The adipose tissue mass was significantly larger in patients with AF compared with patients with sinus rhythm: 10.6 +/- 5.5 versus 4.7 +/- 3.5 g, P<0.001. In a multiple variable model (including age, body mass index, sex, coronary artery calcium score, diabetes mellitus, hypertension, hypercholesterolemia, family history of coronary artery disease, and known coronary artery disease), each gram increase of posterior left atrial adipose tissue was associated with 1.32 odds ratio of having AF (95% confidence interval, 1.22-1.43; P<0.001). Furthermore, the addition of the adipose tissue mass to the multiple variable analysis significantly increased the discriminatory ability to predict AF: increase in the area under the receiver operating characteristic, 0.88 (95% confidence interval, 0.84-0.91) versus 0.81 (0.76-0.85), P<0.001.
Conclusions-Posterior left atrial adipose tissue mass is significantly larger in patients with AF versus without AF. An increase in adipose tissue was independently associated with AF and provided incremental value over well-known predictors of AF. These findings add to the hypothesis that the posterior left atrial adipose tissue mass contributes to structural and electric remodeling leading to AF.

• 出版日期2017-2