title: Pericardial fat is associated with prevalent atrial fibrillation: the Framingham Heart Study.
abstract: BACKGROUND
  Obesity represents an important risk factor for atrial fibrillation (AF). We tested the hypothesis that pericardial fat, a unique fat deposit in close anatomic proximity to cardiac structures and autonomic fibers, is associated with prevalent AF.
  
  
  RESULTS
  Participants from the Framingham Heart Study underwent multidetector computed tomography from 2002 to 2005. We estimated the association between quantitative pericardial, intrathoracic and visceral adipose tissue volumes (per standard deviation of volume) with prevalent AF adjusting for established AF risk factors (age, sex, systolic blood pressure, blood pressure treatment, PR interval, and clinically significant valvular disease). Of the 3217 eligible participants (mean age, 50.6+/-10.1 years; 48% women), 54 had a confirmed diagnosis of AF. Pericardial fat but not intrathoracic or visceral abdominal fat was associated with prevalent AF in multivariable-adjusted models (odds ratio per standard deviation of pericardial fat volume, 1.28; 95% confidence intervals, 1.03 to 1.58). Further adjustments for body mass index, heart failure, myocardial infarction, and intrathoracic fat volume did not materially change the association between pericardial fat and AF.
  
  
  CONCLUSIONS
  Pericardial fat was associated with prevalent AF even after adjustment for AF risk factors, including body mass index. If this association is replicated, further investigations into the mechanisms linking pericardial fat to AF are merited.
authors.affiliation: Framingham Heart Study, Boston University and the National Institutes of Health/National Heart, Lung, and Blood Institute, 73 Mt. Wayte Ave. No. 2, Framingham, MA 01702, USA.
authors.forename: George
authors.initials: G
authors.lastname: Thanassoulis
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Ellinor
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Renate B
authors.initials: RB
authors.lastname: Schnabel
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050154:Adiposity; D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D016017:Odds Ratio; D010496:Pericardium; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed