title: Pericardial fat is independently associated with human atrial fibrillation.
abstract: 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.
authors.affiliation: Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: M Obadah
authors.initials: MO
authors.lastname: Al Chekakie
authors.forename: Christine C
authors.initials: CC
authors.lastname: Welles
authors.forename: Raymond
authors.initials: R
authors.lastname: Metoyer
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Adam R
authors.initials: AR
authors.lastname: Shapira
authors.forename: Joseph
authors.initials: J
authors.lastname: Cytron
authors.forename: Peter
authors.initials: P
authors.lastname: Santucci
authors.forename: David J
authors.initials: DJ
authors.lastname: Wilber
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Akar
mesh_terms: 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