title: Peri-atrial epicardial adipose tissue is associated with new-onset nonvalvular atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is associated with considerable morbidity and mortality in patients with coronary artery disease (CAD). Epicardial adipose tissue (EAT) is recognized as an important inflammatory tissue that may exert deleterious effects on the adjacent left atrial (LA) wall. Multidetector computed tomography (MDCT) can accurately assess EAT's volume and distribution. This study used MDCT to investigate the effect of peri-atrial EAT on new-onset nonvalvular AF.
  
  
  RESULTS
  The study group consisted of 279 patients (176 men; age, 65±10 years) with no history of AF who underwent MDCT examination for evaluation of CAD. EAT was automatically identified on the basis of threshold attenuation values of -30 to -250 Hounsfield units. EAT volume was calculated as the sum of EAT area and subsequently divided into peri-atrial and peri-ventricular EAT. During follow-up of 3.3±1.0 years, AF occurred in 17 (6.1%) patients. Cox proportional hazards regression analysis indicated that male sex, and the LA and peri-atrial EAT volumes (P=0.03, P<0.001, and P<0.001, respectively) were independent predictors for future AF. The sensitivity and specificity for the prediction of AF using a peri-atrial EAT volume index of ≥27 ml/m(2) were 88% and 92%, respectively.
  
  
  CONCLUSIONS
  This is the first study demonstrating that peri-atrial EAT volume estimated by MDCT excellently predicted the development of new-onset AF in patients with CAD, independent of LA enlargement.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Otsuka
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Taguchi
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: Kenei
authors.initials: K
authors.lastname: Shimada
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D010496:Pericardium / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors