Pericardial fat is independently associated with human atrial fibrillation.
OBJECTIVE
The purpose of this study was to investigate the association between atrial fibrillation (AF) and pericardial fat.


BACKGROUND
Pericardial fat is visceral adipose tissue that possesses inflammatory properties. Inflammation and obesity are associated with AF, but the relationship between AF and pericardial fat is unknown.


METHODS
Pericardial fat volume was measured using computed tomography in 273 patients: 76 patients in sinus rhythm, 126 patients with paroxysmal AF, and 71 patients with persistent AF.


RESULTS
Patients with AF had significantly more pericardial fat compared with patients in sinus rhythm (101.6 +/- 44.1 ml vs. 76.1 +/- 36.3 ml, p < 0.001). Pericardial fat volume was significantly larger in paroxysmal AF compared with the sinus rhythm group (93.9 +/- 39.1 ml vs. 76.1 +/- 36.3 ml, p = 0.02). Persistent AF patients had a significantly larger pericardial fat volume compared with paroxysmal AF (115.4 +/- 49.3 ml vs. 93.9 +/- 39.1 ml, p = 0.001). Pericardial fat volume was associated with paroxysmal AF (odds ratio: 1.11; 95% confidence interval: 1.01 to 1.23, p = 0.04) and persistent AF (odds ratio: 1.18, 95% confidence interval: 1.05 to 1.33, p = 0.004), and this association was completely independent of age, hypertension, sex, left atrial enlargement, valvular heart disease, left ventricular ejection fraction, diabetes mellitus, and body mass index.


CONCLUSIONS
Pericardial fat volume is highly associated with paroxysmal and persistent AF independent of traditional risk factors including left atrial enlargement. Whether pericardial fat plays a role in the pathogenesis of AF requires future investigation.
Al Chekakie
M Obadah
MO
Loyola University Medical Center, Maywood, Illinois, USA.
Welles
Christine C
CC
Metoyer
Raymond
R
Ibrahim
Ahmed
A
Shapira
Adam R
AR
Cytron
Joseph
J
Santucci
Peter
P
Wilber
David J
DJ
Akar
Joseph G
JG
D000273:Adipose Tissue / Q000473:pathology / Q000503:physiopathology*; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006332:Cardiomegaly / Q000150:complications; D004452:Echocardiography; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications; D009929:Organ Size; D010496:Pericardium / Q000473:pathology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed