Echocardiographically Measured Epicardial Fat Predicts New-onset Atrial Fibrillation after Cardiac Surgery

Güntürk, Ertuğrul Emre; Topuz, Mustafa; Serhatlıoğlu, Faruk; Akkaya, Hasan

doi:10.21470/1678-9741-2019-0388

Cited by 12 publications

(25 citation statements)

References 26 publications

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“…This seems to clearly contradict a causal relationship between the quantity of adipose tissue and AF, a higher fat mass rather appearing more dependent on the presence of bigger atria, which leads to a higher volume of peri-atrial space sampled. In any case, it should be noted that bias may exist in retrospective studies, and this may pertain, in particular, to the selection of the control group and uncontrolled variables [32,33].…”

Section: Fat Attenuation Versus Volumementioning

confidence: 99%

Atrial Fibrillation and Peri-Atrial Inflammation Measured through Adipose Tissue Attenuation on Cardiac Computed Tomography

et al. 2021

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Background: Inflammation plays a key role in atrial fibrillation (AF). Epicardial adipose tissue around the atrial wall can influence atrial morpho-functional properties. The aim of this study was to assess whether an increased quantity and/or density of adipose tissue located around the left atrium (Fat-LA) are related to AF, independently from atrial size. Methods: eighty patients who underwent AF ablation and 80 patients without history of AF were selected. The Fat-LA mass was quantified as tissue within −190 to −30 Hounsfield Units (HU) on cardiac computed tomography angiograms (CCTA), and the mean adipose tissue attenuation was assessed. Results: Adipose tissue mass was higher in patients with AF (5.42 ± 2.94 mL) versus non-AF (4.16 ± 2.55 mL, p = 0.007), but relative fat quantity did not differ after adjusting for atrial size. Mean fat density was significantly higher in AF (−69.15 HU) versus non-AF (−76.82 HU, p < 0.0001) participants. In the logistic regression models, only the addition of mean Fat-LA attenuation led to a significant improvement of the model’s chi-square (from 22.89 of the clinical model to 31.69 of the clinical and adipose tissue attenuation model, p < 0.01) and discrimination (AUC from 0.775 to 0.829). Conclusions: Fat-LA volume is significantly greater only in absolute terms in patients with AF, but this difference does not hold after adjusting for the larger LA of AF subjects. On the contrary, a higher Fat-LA density was associated with AF, independently from LA size, providing incremental value over other variables that are associated with AF.

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Section: Fat Attenuation Versus Volumementioning

confidence: 99%

Atrial Fibrillation and Peri-Atrial Inflammation Measured through Adipose Tissue Attenuation on Cardiac Computed Tomography

et al. 2021

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“…Since then, more than 10 studies have been performed on this topic. However, they have been done in different populations and included different procedures (coronary artery bypass grafting or valve replacement) with different EAT measurements (computed tomography [CT] and echocardiography) and diverse intervals of follow up [Rachwalik 2019;Drossos 2014;Wang 2019;Opolski 2015;Kogo 2019;Liu 2020;Gunturk 2020;Ozbek 2018]. This study is the first attempt to prove the association between AFACS and EAT in patients with and without AF following cardiac surgery, via systematic review, and meta-analysis.…”

Section: E802mentioning

confidence: 99%

“…After reading the full text of the 37 remaining articles, 29 articles were excluded because of a lack of EAT measurement (N = 11), cardiac surgery (N = 13), AF (N = 2), or comparisons (N = 3). Ultimately, the 10 studies published in eight articles [Rachwalik 2019;Drossos 2014;Wang 2019;Opolski 2015;Kogo 2019;Liu 2020;Gunturk 2020;Ozbek 2018] with three sub-groups were included in the study (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Five studies [Rachwalik 2019;Wang 2019;Liu 2020;Gunturk 2020] (334 patients) assessed EAT thickness using echocardiography. Patients with AFACS had a significantly higher EAT thickness than those without AFACS (SMD = 0.85 mm, 95% CI = 0.04-1.65, P = .04; I 2 = 90%) (Figure 2B).…”

Section: Epicardial Fat Thicknessmentioning

confidence: 99%

“…Furthermore, age, indication of cardiac surgery and EAT measured area, BMI, as well as other classical AF risk factors, were extra probable origins of heterogeneity, which we were unable to evaluate without detailed data. According to the sensitivity analysis (Table 2A), it is suggested that the study by Gunturk et al [Gunturk 2020] could be one of the sources of heterogeneity. (Table 2A) The endpoint of other studies was AF, which was defined according to the European Society of Cardiology guidelines for the management of atrial fibrillation.…”

Section: Cause Of Heterogeneitymentioning

confidence: 99%

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Is Epicardial Adipose Tissue Associated with Atrial Fibrillation Following Cardiac Surgery? A Systematic Review and Meta-Analysis

Sha

Han

Lin

et al. 2021

HSF

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Background: Although epicardial adipose tissue (EAT) has been proven to be related to atrial fibrillation (AF) and post-ablation AF recurrence, the association between EAT and AF after cardiac surgery (AFACS) remains unclear. Objective: This study was a systematic review and meta-analysis that assessed the relationship between EAT and AFACS. Methods: Electronic databases were systematically searched for “atrial fibrillation” and “epicardial adipose tissue.” The analysis was stratified according to the EAT measurement into three meta-analyses as (1) total EAT volume, (2) left atrial (LA)-EAT volume, and (3) EAT thickness. Standardized mean difference (SMD) was estimated using a random effects model. Results: Eight articles with 10 studies (546 patients) were included. The meta-analysis revealed that EAT was higher in those with AFACS irrespective of the EAT measurement (total EAT volume: SMD = 0.56 mL, 95% confidence interval, CI = 0.56–1.10 mL, I2 = 0.90, P = .04; EAT thickness: SMD = 0.85 mm, 95% CI = 0.04–1.65 mm, I2 = 0.90, P = .04; LA-EAT volume: SMD = 0.57 mL, 95% CI = 0.23–0.92 mL, I2 = 0.00, P = .001). Conclusion: EAT was higher in patients with AFACS, measured either as volume or thickness.

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Fat chance for POAF? Pericardial adipose tissue and the arrhythmogenic substrate for postoperative atrial fibrillation

Gawałko

Dobrev

2022

IJC Heart & Vasculature

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Echocardiographically Measured Epicardial Fat Predicts New-onset Atrial Fibrillation after Cardiac Surgery

Cited by 12 publications

References 26 publications

Atrial Fibrillation and Peri-Atrial Inflammation Measured through Adipose Tissue Attenuation on Cardiac Computed Tomography

Atrial Fibrillation and Peri-Atrial Inflammation Measured through Adipose Tissue Attenuation on Cardiac Computed Tomography

Is Epicardial Adipose Tissue Associated with Atrial Fibrillation Following Cardiac Surgery? A Systematic Review and Meta-Analysis

Fat chance for POAF? Pericardial adipose tissue and the arrhythmogenic substrate for postoperative atrial fibrillation

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