title: Quantitative analysis of quantity and distribution of epicardial adipose tissue surrounding the left atrium in patients with atrial fibrillation and effect of recurrence after ablation.
abstract: Epicardial adipose tissue (EAT) contains ganglionated plexuses and adipocytes that can affect the pathogenesis of atrial fibrillation (AF). The aim of this study was to quantify the EAT surrounding the left atrium (LA) and correlate it with occurrence of AF and outcome after catheter ablation. EAT was evaluated using 64-slice multidetector computed tomography in 68 patients with AF and 34 controls. EAT volume was acquired by semiautomatically tracing axial images from the pulmonary artery to the coronary sinus. Topographic distribution of EAT was assessed by dividing the periatrial space into 8 equal regions. EAT volume significantly increased in patients with AF than in controls (29.9 ± 12.1 vs 20.2 ± 6.5 cm(3), p <0.001). Most EAT was located in regions (1) within the superior vena cava, right pulmonary artery, and right-sided roof of the LA (29.8%), (2) within the aortic root, pulmonary trunk, and left atrial appendage (26.5%), and (3) between the left inferior pulmonary vein and left atrioventricular groove (18.1%). Baseline variables were analyzed in patients with (n = 24) and without (n = 44) AF recurrence after ablation. The recurrent group showed significantly increased EAT (35.2 ± 12.5 vs 26.8 ± 11.1 cm(3), p = 0.007). Multivariate analysis revealed that EAT was an independent predictor of AF recurrence after ablation (p = 0.038). In conclusion, EAT of LA was increased in patients with AF. Large clusters of EAT were observed adjacent to the anterior roof, left atrial appendage, and lateral mitral isthmus. Abundance of EAT was independently related to AF recurrence after ablation.
authors.affiliation: Division of Cardiology, National Yang Ming University Hospital and National Yang Ming University, Yi-Lan, Taiwan. hmtsao.pohai@msa.hinet.net
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Hu
authors.forename: Mei-Han
authors.initials: MH
authors.lastname: Wu
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Tsu-Juey
authors.initials: TJ
authors.lastname: Wu
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Sheu
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chang
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology*; D001281:Atrial Fibrillation / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010496:Pericardium / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012008:Recurrence; D016896:Treatment Outcome