title: Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation.
abstract: BACKGROUND
  Obesity and pericardial adipose tissue are independent risk factors for atrial fibrillation (AF) and adverse cardiac structural remodeling. The effect of weight reduction on pericardial adipose tissue and cardiac structure remains unknown.
  
  
  METHODS
  We prospectively performed cardiac magnetic resonance imaging on 87 participants with AF undergoing either structured weight management (intervention) or general lifestyle advice (control). We measured pericardial adipose tissue, atrial and ventricular volumes, and myocardial mass at baseline and 12 months.
  
  
  RESULTS
  In total, 69 participants underwent baseline and 12-month follow-up cardiac magnetic resonance imaging (intervention n = 36 and controls n = 33). From baseline to 12 months, weight loss (kg, mean [95% CI]) was greater in the intervention group from 101.5 kg (97.2-105.8 kg) to 86.5 kg (81.2-91.9 kg) as compared with controls from 102.6 kg (97.2-108.1 kg) to 98.7 kg (91.0-106.3 kg) (time-group interaction P < .001). The intervention group showed a reduction in left atrial volumes (mL) from 105.0 mL (98.9-111.1 mL) to 96.4 mL (91.6-101.1 mL), whereas the change in the control group was from 108.8 mL (99.6-117.9 mL) to 108.9 mL (99.8-118.0 mL) (time-group interaction P < .001). There was a decline in pericardial adipose tissue (cm(3)) from 140.9 cm(3) (129.3-152.4 cm(3)) to 118.8 cm(3) (108.1-129.6 cm(3)) and myocardial mass (g) from 137.6 g (128.1-147.2 g) to 123.1 g (114.5-131.7 g) in the intervention group, whereas the change in the control group was from 143.2 cm(3) (124.6-161.7 cm(3)) to 147.2 cm(3) (128.9-165.4 cm(3)) for pericardial adipose tissue and 138.3 g (124.8-151.8 g) to 140.7 g (127.4-154.1 g) for myocardial mass (both variables, time-group interaction P < .001).
  
  
  CONCLUSIONS
  Weight reduction results in favorable structural remodeling and a reduction in pericardial adipose tissue burden.
authors.affiliation: NHMRC Clinical Trials Center, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia; University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia. Electronic address: habed@gmp.usyd.edu.au.
authors.forename: Hany S
authors.initials: HS
authors.lastname: Abed
authors.affiliation: University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Nelson
authors.affiliation: University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: James D
authors.initials: JD
authors.lastname: Richardson
authors.affiliation: University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Worthley
authors.affiliation: University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Vincent
authors.affiliation: University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Wittert
authors.affiliation: University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia; The Population Health Research Institute, Hamilton Health Sciences, and McMaster University, Ontario, Canada.
authors.forename: Darryl P
authors.initials: DP
authors.lastname: Leong
mesh_terms: D000273:Adipose Tissue; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008019:Life Style; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D009765:Obesity / Q000150:complications; D010496:Pericardium / Q000473:pathology*; D011446:Prospective Studies; D015431:Weight Loss