Modulation of Cardiac Arrhythmogenesis by Epicardial Adipose Tissue

Ernault, Auriane C.; Meijborg, Veronique M.F.; Coronel, Ruben

doi:10.1016/j.jacc.2021.08.037

Cited by 75 publications

(71 citation statements)

References 96 publications

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“…However, the causal relationship between VAT mass and a wide range of CVD outcomes is still unclear, and the potential mechanism is unknown. Most experimental studies about the relationship between VAT and CVDs focus on the impact of specific depots of VAT on CVDs, like EAT ( Wong et al, 2017 ; Packer, 2018 ; Ernault et al, 2021 ) PAT ( Al Chekakie et al, 2010 ; Thanassoulis et al, 2010 ), and PVAT ( Xia and Li, 2017 ), but not the impact of overall VAT.…”

Section: Discussionmentioning

confidence: 99%

Associations of Visceral Adipose Tissue, Circulating Protein Biomarkers, and Risk of Cardiovascular Diseases: A Mendelian Randomization Analysis

Huang

Liu

et al. 2022

Front. Cell Dev. Biol.

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Aim: To evaluate the genetic associations of visceral adipose tissue (VAT) mass with metabolic risk factors and cardiovascular disease (CVD) endpoints and to construct a network analysis about the underlying mechanism using Mendelian randomization (MR) analysis.Methods and Results: Using summary statistics from genome-wide association studies (GWAS), we conducted the two-sample MR to assess the effects of VAT mass on 10 metabolic risk factors and 53 CVD endpoints. Genetically predicted VAT mass was associated with metabolic risk factors, including triglyceride (odds ratio, OR, 1.263 [95% confidence interval, CI, 1.203–1.326]), high-density lipoprotein cholesterol (OR, 0.719 [95% CI, 0.678–0.763]), type 2 diabetes (OR, 2.397 [95% CI, 1.965–2.923]), fasting glucose (OR, 1.079 [95% CI, 1.046–1.113]), fasting insulin (OR, 1.194 [95% CI, 1.16–1.229]), and insulin resistance (OR, 1.204 [95% CI, 1.16–1.25]). Genetically predicted VAT mass was associated with CVD endpoints, including atrial fibrillation (OR, 1.414 [95% CI, 1.332 = 1.5]), coronary artery disease (OR, 1.573 [95% CI, 1.439 = 1.72]), myocardial infarction (OR, 1.633 [95% CI, 1.484 =1.796]), heart failure (OR, 1.711 [95% CI, 1.599–1.832]), any stroke (OR, 1.29 [1.193–1.394]), ischemic stroke (OR, 1.292 [1.189–1.404]), large artery stroke (OR, 1.483 [1.206–1.823]), cardioembolic stroke (OR, 1.261 [1.096–1.452]), and intracranial aneurysm (OR, 1.475 [1.235–1.762]). In the FinnGen study, the relevance of VAT mass to coronary heart disease, stroke, cardiac arrhythmia, vascular diseases, hypertensive heart disease, and cardiac death was found. In network analysis to identify the underlying mechanism between VAT and CVDs, VAT mass was positively associated with 23 cardiovascular-related proteins (e.g., Leptin, Hepatocyte growth factor, interleukin-16), and inversely with 6 proteins (e.g., Galanin peptides, Endothelial cell-specific molecule 1). These proteins were further associated with 32 CVD outcomes.Conclusion: Mendelian randomization analysis has shown that VAT mass was associated with a wide range of CVD outcomes including coronary heart disease, cardiac arrhythmia, vascular diseases, and stroke. A few circulating proteins may be the mediators between VAT and CVDs.

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Section: Discussionmentioning

confidence: 99%

Associations of Visceral Adipose Tissue, Circulating Protein Biomarkers, and Risk of Cardiovascular Diseases: A Mendelian Randomization Analysis

Huang

Liu

et al. 2022

Front. Cell Dev. Biol.

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“…There are also several other less-understood potential mechanisms which may explain the involvement of EAT in the pathogenesis of AF, such as the local aromatase effect [113][114][115]. A significant positive correlation was determined between the total aromatase content of EAT and the occurrence/duration of triggered atrial arrhythmias [114].…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

Konwerski

Opolski

Grabowski

et al. 2022

Biology

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Cardiovascular diseases (CVDs) are the leading causes of death worldwide. Epicardial adipose tissue (EAT) is defined as a fat depot localized between the myocardial surface and the visceral layer of the pericardium and is a type of visceral fat. EAT is one of the most important risk factors for atherosclerosis and cardiovascular events and a promising new therapeutic target in CVDs. In health conditions, EAT has a protective function, including protection against hypothermia or mechanical stress, providing myocardial energy supply from free fatty acid and release of adiponectin. In patients with obesity, metabolic syndrome, or diabetes mellitus, EAT becomes a deleterious tissue promoting the development of CVDs. Previously, we showed an adverse modulation of gene expression in pericoronary adipose tissue in patients with coronary artery disease (CAD). Here, we summarize the currently available evidence regarding the role of EAT in the development of CVDs, including CAD, heart failure, and atrial fibrillation. Due to the rapid development of the COVID-19 pandemic, we also discuss data regarding the association between EAT and the course of COVID-19. Finally, we present the potential therapeutic possibilities aiming at modifying EAT’s function. The development of novel therapies specifically targeting EAT could revolutionize the prognosis in CVDs.

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“…This can be explained by one of the mechanisms previously described in literature. The first is the direct infiltration of the myocardium by adipocytes, which leads to the formation of tissue and electrical heterogeneity, following by LA structural remodeling [39]. The second mechanismis induction of inflammation and fibrosis in the myocardium due to the secretion of proinflammatory cytokines by adipose tissue itself [6,40].…”

Section: Discussionmentioning

confidence: 99%

Radiomic phenotype of epicardial adipose tissue in the prognosis of atrial fibrillation recurrence after catheter ablation in patients with isolated atrial fibrillation.

Ilyushenkova

Сазонова

Popov

et al. 2022

Preprint

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BackgroundTo estimate the utility of pre-procedural CT-radiomic analysis of epicardial adipose tissue (EAT), and to identify patients at risk for isolated atrial fibrillation (AF) recurrence after catheter ablation (CA).MethodsThe study population (63 patients) consisted of study group (Group 1) and comparative group (Group 2). 43 patients with isolated AF referred for CA. Before CA, all of them underwent multidetector computed tomography coronary angiography. Segmentation and subsequent radiomic analysis of EAT were performed on calcium scoring series of 3D DICOM images using by 3D-Slicer. ResultsEpicardial adipose tissue in patients with isolated AF had a distinct radiomic phenotype. Thus, 45 of 93 calculated radiomic parameters of EAT, as well as EAT volume and attenuation, were significantly different between patients with isolated AF (Group 1) and persons without any arrhythmia (Group 2). Moreover, 17 radiomic parameters were significantly different in subgroups with and without AF recurrence (Group 1a and Group 1b). Multivariate regression analysis demonstrated that among all radiomic parameters only Gray Level Non-Uniformity Normalized (GLSZM) was an independent predictor of AF recurrence (OR 0.10027, 95%CI 1.0009-1.0044, p=0.002). ROC-curve analysis data showed that GLSZM >1227.4 indicates high probability of AF recurrence during 12 months (sensitivity 89.4 %, specificity 70.8 %, AUC: 0.809; p=0.001).ConclusionThe radiomic parameter GLSZM is associated with late AF recurrence after CA in patients with isolated AF. In current study GLSZM was a stronger predictor of isolated AF recurrence in multivariate analysis comparing with other established risk factors and EAT volume and attenuation.

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Modulation of Cardiac Arrhythmogenesis by Epicardial Adipose Tissue

Cited by 75 publications

References 96 publications

Associations of Visceral Adipose Tissue, Circulating Protein Biomarkers, and Risk of Cardiovascular Diseases: A Mendelian Randomization Analysis

Associations of Visceral Adipose Tissue, Circulating Protein Biomarkers, and Risk of Cardiovascular Diseases: A Mendelian Randomization Analysis

Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

Radiomic phenotype of epicardial adipose tissue in the prognosis of atrial fibrillation recurrence after catheter ablation in patients with isolated atrial fibrillation.

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