Pericardial fat is strongly associated with atrial fibrillation after coronary artery bypass graft surgery†

Abstract

PFV is strongly associated with AF following CABG, independently of many traditional risk factors. Our findings suggest that PFV may represent a novel risk factor for postoperative AF. However, the role of pericardial fat in AF mechanism needs to be further delineated.

Computed tomography angiography for prediction of atrial fibrillation after coronary artery bypass grafting: Proof of concept

“…This corresponds well with our findings, not only confirming the independent relationship between postoperative AF and EAT volume, but also extending prior observations to the role of regional EAT located around the LA in the onset of postoperative AF. Of note, the study of Drossos et al was limited to application of 4-slice computed tomographic scanner and examination of only a single CCTA parameter rather than performance of a comprehensive CCTA analysis [12]. Thus, only our report introduces noninvasive CCTA as a potential gatekeeper for refined AF risk stratification, as depicted by the ROC analysis showing good negative predictive value of the LA EAT volume >3.4 ml for exclusion of postoperative AF.…”

“…CCTA has been introduced as a useful noninvasive tool that demonstrates high performance for assessing the anatomical features of PVs and LA, and has been successfully employed in the planning of ablation procedures [6,17]. In the only study assessing the potential application of CCTA for prediction of AF after CABG, Drossos et al reported the total volume of EAT surrounding the entire heart to be independently associated with postoperative AF [12]. This corresponds well with our findings, not only confirming the independent relationship between postoperative AF and EAT volume, but also extending prior observations to the role of regional EAT located around the LA in the onset of postoperative AF.…”

“…The volume and radiodensity of the LA epicardial adipose tissue (EAT) were calculated with the same software tool by using a window of À200 to À30 Hounsfield units within the limits of the pericardial sac in the diastolic phase of the cardiac cycle ( Fig. 1) [12]. To assess the regional characteristics of the LA EAT, the thickness of the periatrial fat was measured in the short-axis view at the level of the mid LA as the shortest distance between the LA wall and three anatomic landmarks: esophagus, main pulmonary artery, and descending thoracic aorta as previously described [13].…”

Role of red blood cell distribution width and epicardial fat in atrial fibrillation after cardiopulmonary bypass

“…EAT is metabolically active tissue and is thought to be a source of inflammatory cytokines. Several tomographic studies have shown that EAT volume is associated with cardiac arrhythmias, especially the development of AF in surgical and non-surgical patients (8,9). Al Chekakie et al (14) suggested that EAT volume is a strong independent factor aside from traditional risk factors in the development of paroxysmal and persistent AF.…”

“…Epicardial adipose tissue (EAT) and the myocardium are not separated by fascia, and therefore share the same microcirculation. EAT is an active tissue with inflammatory and endocrine features, and it plays a crucial role in the pathogenesis of cardiac arrhythmias (8,9). Red blood cell distribution width (RDW), or anisocytosis, is an indicator of variability in the size of erythrocytes.…”