Pericardial fat is strongly associated with atrial fibrillation after coronary artery bypass graft surgery†

Drossos, George; Koutsogiannidis, Charilaos-Panagiotis; Ananiadou, Olga; Kapsas, Georgios; Ampatzidou, Fotini; Madesis, Athanasios; Bismpa, K.; Palladas, Panagiotis; Karagounis, Labros A.

doi:10.1093/ejcts/ezu043

Cited by 33 publications

(18 citation statements)

References 23 publications

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“…This corresponds well with our findings, not only confirming the independent relationship between postoperative AF and EAT volume, but also extending prior observations to the role of regional EAT located around the LA in the onset of postoperative AF. Of note, the study of Drossos et al was limited to application of 4-slice computed tomographic scanner and examination of only a single CCTA parameter rather than performance of a comprehensive CCTA analysis [12]. Thus, only our report introduces noninvasive CCTA as a potential gatekeeper for refined AF risk stratification, as depicted by the ROC analysis showing good negative predictive value of the LA EAT volume >3.4 ml for exclusion of postoperative AF.…”

Section: Discussionmentioning

confidence: 79%

“…CCTA has been introduced as a useful noninvasive tool that demonstrates high performance for assessing the anatomical features of PVs and LA, and has been successfully employed in the planning of ablation procedures [6,17]. In the only study assessing the potential application of CCTA for prediction of AF after CABG, Drossos et al reported the total volume of EAT surrounding the entire heart to be independently associated with postoperative AF [12]. This corresponds well with our findings, not only confirming the independent relationship between postoperative AF and EAT volume, but also extending prior observations to the role of regional EAT located around the LA in the onset of postoperative AF.…”

Section: Discussionmentioning

confidence: 99%

“…The volume and radiodensity of the LA epicardial adipose tissue (EAT) were calculated with the same software tool by using a window of À200 to À30 Hounsfield units within the limits of the pericardial sac in the diastolic phase of the cardiac cycle ( Fig. 1) [12]. To assess the regional characteristics of the LA EAT, the thickness of the periatrial fat was measured in the short-axis view at the level of the mid LA as the shortest distance between the LA wall and three anatomic landmarks: esophagus, main pulmonary artery, and descending thoracic aorta as previously described [13].…”

Section: Ccta Analysismentioning

confidence: 99%

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Computed tomography angiography for prediction of atrial fibrillation after coronary artery bypass grafting: Proof of concept

Opolski

Staruch

Kuśmierczyk

et al. 2015

Journal of Cardiology

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Ccta Analysismentioning

confidence: 99%

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Computed tomography angiography for prediction of atrial fibrillation after coronary artery bypass grafting: Proof of concept

Opolski

Staruch

Kuśmierczyk

et al. 2015

Journal of Cardiology

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“…EAT is metabolically active tissue and is thought to be a source of inflammatory cytokines. Several tomographic studies have shown that EAT volume is associated with cardiac arrhythmias, especially the development of AF in surgical and non-surgical patients (8,9). Al Chekakie et al (14) suggested that EAT volume is a strong independent factor aside from traditional risk factors in the development of paroxysmal and persistent AF.…”

Section: Discussionmentioning

confidence: 99%

“…Epicardial adipose tissue (EAT) and the myocardium are not separated by fascia, and therefore share the same microcirculation. EAT is an active tissue with inflammatory and endocrine features, and it plays a crucial role in the pathogenesis of cardiac arrhythmias (8,9). Red blood cell distribution width (RDW), or anisocytosis, is an indicator of variability in the size of erythrocytes.…”

Section: Introductionmentioning

confidence: 99%

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

et al. 2018

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Objective: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, and it remains a challenge for cardiac surgeons despite advances in medicine. A number of studies have been performed to examine various parameters to predict which patients will develop POAF. The present study was performed to investigate the roles of epicardial adipose tissue (EAT) volume and red blood cell distribution width (RDW) as predictors of POAF. Methods: The medical records of 350 patients undergoing coronary artery bypass grafting in one or more vessels at the Tertiary Cardiac Center, Cardiovascular Surgery Department, Mevlana (Rumi) University Private Hospital (Konya, Turkey), were screened between December 2011 and May 2015. The study population consisted of 149 patients fulfilling the inclusion criteria and undergoing a preoperative evaluation by computed chest tomography. All patient demographics and laboratory parameters were obtained from medical records. Results: Age, postoperative RDW, and tomography variables, including the left atrial (LA) volume, LA diameters, and EAT volume, were significantly higher while the hemoglobin level and hematocrit were significantly lower in patients developing atrial fibrillation after cardiopulmonary bypass. A logistic multivariate regression analysis was performed on age, postoperative RDW, and tomography variables, including LA volume, LA diameters and EAT volume. Only age (OR 1.0731, 95% CI 1.012-1.138; p = 0.018) was an independent predictor of the development of POAF. Conclusions: Although the EAT volume was high in patients developing atrial fibrillation after surgery, age was the only significant predictor of POAF on multivariate analysis. Additional studies regarding the predictive roles of epicardial fat and RDW in POAF are needed.

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Injectable ice slurry for reducing pericardial adipose tissue

Shuhaiber,

Moradi Tuchayi,

Bijari

et al. 2023

Lasers Surg Med

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ObjectivesExcess pericardial adipose tissue (PAT) is associated with a higher risk of cardiovascular diseases. Currently, available methods for reducing PAT volume include weight loss through diet and exercise, weight loss with medications, and bariatric surgery. However, these methods are all limited by low patient compliance to maintain the results. We have developed an injectable ice slurry that could selectively target and reduce subcutaneous adipose tissue volume. The aim of this study was to investigate the feasibility and safety of using injectable slurry to selectively reduce PAT volume in a preclinical large animal model.MethodsPAT in Yucatan swine was injected with slurry or room temperature control solution. All animals were imaged with baseline chest computed tomography (CT) before slurry injection and at 2 months after injection to quantify PAT volume. Specimens from injected and noninjected PAT were harvested for histology.ResultsSlurry treatment of PAT was well tolerated in all animals. Slurry‐induced selective cryolipolysis in treated PAT. CT imaging showed decrease in PAT volume in treated area at 8 weeks posttreatment compared to baseline, that was significantly different from control solution treated group (median [range]: −29.66 [−35.07 to −27.92]% vs. −1.50 [−11.69 to 8.69]% in control animals respectively, p < 0.05).ConclusionsThis study demonstrated that slurry injection into PAT is feasible in a large animal model. Slurry injection was safe and effective in inducing selective cryolipolysis in PAT and reducing PAT volume. Slurry reduction of PAT could potentially serve as a novel treatment for cardiovascular diseases.

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Pericardial fat is strongly associated with atrial fibrillation after coronary artery bypass graft surgery†

Abstract: PFV is strongly associated with AF following CABG, independently of many traditional risk factors. Our findings suggest that PFV may represent a novel risk factor for postoperative AF. However, the role of pericardial fat in AF mechanism needs to be further delineated.

Cited by 33 publications

References 23 publications

Computed tomography angiography for prediction of atrial fibrillation after coronary artery bypass grafting: Proof of concept

Computed tomography angiography for prediction of atrial fibrillation after coronary artery bypass grafting: Proof of concept

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

Injectable ice slurry for reducing pericardial adipose tissue

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