title: Cardiac adipose tissue and atrial fibrillation: the perils of adiposity.
abstract: The amount of adipose tissue that accumulates around the atria is associated with the risk, persistence, and severity of atrial fibrillation (AF). A strong body of clinical and experimental evidence indicates that this relationship is not an epiphenomenon but is the result of complex crosstalk between the adipose tissue and the neighbouring atrial myocardium. For instance, epicardial adipose tissue is a major source of adipokines, inflammatory cytokines, or reactive oxidative species, which can contribute to the fibrotic remodelling of the atrial myocardium. Fibro-fatty infiltrations of the subepicardium could also contribute to the functional disorganization of the atrial myocardium. The observation that obesity is associated with distinct structural and functional remodelling of the atria has opened new perspectives of treating AF substrate with aggressive risk factor management. Advances in cardiac imaging should lead to an improved ability to visualize myocardial fat depositions and to localize AF substrates.
authors.affiliation: Sorbonne University, Faculté de médicine, Assistance Publique-Hôpitaux de Paris, GH Pitié-Salpêtrière Hospital, INSERM UMR_S1166, Cardiology Department, Institute of Cardiometabolism and Nutrition-ICAN, 91, boulevard de l'hôpital, 75013 Paris, France stephane.hatem@upmc.fr.
authors.forename: Stéphane N
authors.initials: SN
authors.lastname: Hatem
authors.affiliation: Sorbonne Universités, Université Pierre et Marie Curie UPMC, Laboratoire d'imagerie biomédicale INSERM UMR_S1146, Cardiovascular Imaging Department, ICAN Imaging Core Lab, Paris, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Redheuil
authors.affiliation: Sorbonne University, Faculté de médicine, Assistance Publique-Hôpitaux de Paris, GH Pitié-Salpêtrière Hospital, INSERM UMR_S1166, Cardiology Department, Institute of Cardiometabolism and Nutrition-ICAN, 91, boulevard de l'hôpital, 75013 Paris, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Gandjbakhch
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D050154:Adiposity / Q000502:physiology*; D000818:Animals; D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology*; D006325:Heart Atria / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000378:metabolism
keywords: Adipokines; Adipose tissue; Atrial fibrillation; Atrial fibrosis