Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome

Stojanovska, Jadranka; Kazerooni, Ella A.; Sinno, Mohamad; Gross, Barry H.; Watcharotone, Kuanwong; Patel, Smita; Jacobson, Jon A.; Oral, Hakan

doi:10.1007/s00330-015-3643-1

Cited by 45 publications

(30 citation statements)

References 38 publications

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“…Epicardial fat volume (EFV) has been correlated with numerous disease processes including coronary artery disease, atrial fibrillation and diabetes [1-5]. It has been demonstrated that epicardial fat is metabolically different from other visceral fat both biochemically and in terms of its correlation to cardiac risk factors [6-9].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature

et al. 2015

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Objectives To perform a systematic review of the growing body of literature evaluating the prognostic value of epicardial fat volume (EFV) quantified by cross-sectional imaging for adverse clinical outcomes. Methods Two independent reviewers performed systematic searches on both PubMed and Scopus using search terms developed with a medical librarian. Peer-reviewed articles were selected based on the inclusion of outcome data, utilization of epicardial fat volume and sufficient reporting for analysis. Results A total of 411 studies were evaluated with 9 studies meeting the inclusion criteria. In all, the studies evaluated 10,252 patients. All 9 studies were based on CT measurements. Seven studies evaluated the prognostic value of EFV unadjusted for calcium score, and 6 of these studies found a significant association between EFV and clinical outcomes. Seven studies evaluated the incremental value of EFV beyond calcium scoring, and 6 of these studies found a significant association. Conclusions The majority of studies suggest that EFV quantification is significantly associated with clinical outcomes and provides incremental prognostic value over coronary artery calcium scoring. Future research should use a binary cut-off of 125mL for evaluation of EFV to provide consistency with other research.

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Section: Introductionmentioning

confidence: 99%

Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature

et al. 2015

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“…Extrapericardial fat volume (EPFV) was calculated as a difference between ITFV and EFV (Fig 2). We previously showed no significant inter-reader variability in intrathoracic fat measurements (13,32). …”

Section: Methodsmentioning

confidence: 86%

“…All patients were premedicated with one puff of sublingual nitroglycerin 1–5 minutes before scanning, and only patients with a heart rate over 65 beats per minute received 100 mg metoprolol orally 60 minutes before CT. CT calcium scoring technique used cine mode with scan parameters that included 0.35-second gantry rotation speed, 2.5-mm slice thickness, and 120 kVp, adjusted for patient size. CCTA portion with IV contrast was previously described (13,32). …”

Section: Methodsmentioning

confidence: 99%

“…Slices were properly windowed to determine the border between the mediastinum and the lungs. The ITFV and EFV were defined as the fat inside the tracing, calculated by designating an attenuation threshold that would isolate fat (13). The threshold range was set at −250 Hounsfield units (HU) to −50 HU (33).…”

Section: Methodsmentioning

confidence: 99%

“…Increased epicardial adipose tissue (EAT) has been associated with autoimmune disorders, such as psoriasis (5) and rheumatoid arthritis (6), and with cardiometabolic diseases such as type 2 diabetes mellitus (7), coronary artery disease (CAD) (8–11), and atrial fibrillation (12,13). It is postulated that close proximity of the increased EAT to the heart and vessels (14) and the lack of a physical barrier between these structures allow for diffusion of proinflammatory cytokines that could play role in the development of cardiometabolic diseases (14–16).…”

Section: Introductionmentioning

confidence: 99%

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Increased Epicardial Fat Volume Is Independently Associated with the Presence and Severity of Systemic Sclerosis

Long

Stojanovska²,

Brown

et al. 2017

Academic Radiology

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Rationale and Objectives The study aimed to determine if intrathoracic fat volumes are associated with the presence and severity of systemic sclerosis (SSc), defined by the presence of pulmonary arterial hypertension (PAH). Materials and Methods A total of 265 patients were included in the study, 202 of whom had SSc (134 had SSc with no PAH and 68 had SSc-associated PAH) and who underwent high-resolution computed tomography, and 63 controls who underwent coronary computed tomography angiography with calcium scoring. Intrathoracic and epicardial (EFV) fat volumes were quantified by manual tracing of the mediastinum and the pericardium, the difference of which represents the extrapericardial fat volume. Associations between these three fat volumes and the presence and severity of SSc, adjusted for cardiovascular risk factors and interstitial lung disease, were evaluated by logistic regression analysis. Results Of the 202 patients with SSc, the mean age was 54 years (ranged from 20 to 86), and 79% (192 of 202) were women. Adjusted EFV (odds ratio [OR]: 1.065; 95% confidence interval [CI]: 1.046–1.084, P = < 0.0001), ≤extrapericardial fat volume (OR: 1.028, 95% CI: 1.017–1.038, P = < 0.0001), and intrathoracic fat volume (OR: 1.033, 95% CI: 1.023–1.043, P = 0.001) were associated with the presence of SSc. Only EFV was associated with SSc severity (adjusted OR: 1.010, 95% CI: 1.003–1.018, P = 0.007). Conclusion Increased epicardial fat volume is associated with the presence and severity of SSc, independent of cardiovascular risk factors and interstitial lung disease.

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Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

Gaborit

Sengenès

Ancel

et al. 2017

Comprehensive Physiology

122

109

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Epicardial adipose tissue (EAT) is a small but very biologically active ectopic fat depot that surrounds the heart. Given its rapid metabolism, thermogenic capacity, unique transcriptome, secretory profile, and simply measurability, epicardial fat has drawn increasing attention among researchers attempting to elucidate its putative role in health and cardiovascular diseases. The cellular crosstalk between epicardial adipocytes and cells of the vascular wall or myocytes is high and suggests a local role for this tissue. The balance between protective and proinflammatory/profibrotic cytokines, chemokines, and adipokines released by EAT seem to be a key element in atherogenesis and could represent a future therapeutic target. EAT amount has been found to predict clinical coronary outcomes. EAT can also modulate cardiac structure and function. Its amount has been associated with atrial fibrillation, coronary artery disease, and sleep apnea syndrome. Conversely, a beiging fat profile of EAT has been identified. In this review, we describe the current state of knowledge regarding the anatomy, physiology and pathophysiological role of EAT, and the factors more globally leading to ectopic fat development. We will also highlight the most recent findings on the origin of this ectopic tissue, and its association with cardiac diseases. © 2017 American Physiological Society. Compr Physiol 7:1051-1082, 2017.

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Increased epicardial fat is independently associated with the presence and chronicity of atrial fibrillation and radiofrequency ablation outcome

Abstract: • Increased epicardial fat is associated with presence and chronicity of atrial fibrillation • Extensive epicardial fat is associated with earlier recurrences of AF after ablation • Extensive epicardial fat may reduce transmurality of ablation by affecting current dynamics.

Cited by 45 publications

References 38 publications

Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature

Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature

Increased Epicardial Fat Volume Is Independently Associated with the Presence and Severity of Systemic Sclerosis

Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat?

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