Left atrial epicardial adiposity and atrial fibrillation.
Left atrial epicardial adiposity and atrial fibrillation.
复制标题
DOI：
10.1161/circep.110.957241
复制
发表时间：
2010-06
期刊：
影响因子：
--
通讯作者：
Chung MK
中科院分区：
文献类型：
--
作者：
Batal O;Schoenhagen P;Shao M;Ayyad AE;Van Wagoner DR;Halliburton SS;Tchou PJ;Chung MK
心房颤动（AF）与炎症因子和肥胖有关。心外膜脂肪是与冠状动脉疾病发展相关的几种炎症介质的来源。我们假设心房周围脂肪在房颤的发生中可能具有类似的作用。在冠状动脉疾病或房颤的连续心脏CT血管造影中测量左心房（LA）心外膜脂肪垫厚度。患者按房颤负荷分组：无（n=73）、阵发性（n=60）或持续性（n=36）AF。在左心房中段的短轴视图中，测量食管处的心房周围心外膜脂肪厚度（LA-ESO），主肺动脉和胸主动脉;胸骨后脂肪在轴向视图中测量（右冠状动脉口水平）。在四腔切面上确定左心房面积。持续性AF患者的LA-ESO脂肪较阵发性AF（P=0.011）或无AF（P=0.003）患者更厚。持续性房颤患者左心房面积大于阵发性房颤（P=0.004）或无房颤患者（P<0.001）。即使在调整年龄、体重指数和左心房面积后，左心房-ESO仍是房颤负荷的重要预测因素（比值比，5.30; 95%置信区间，1.39 - 20.24; P=0.015）。还进行了包括年龄、体重指数、左心房面积和合并症的倾向评分调整的多变量逻辑回归，相关性保持统计学显著性（P=0.008）。左心房后壁脂肪厚度增加似乎与房颤负荷相关，与年龄、体重指数或左心房面积无关。进一步的研究是必要的，以检查因果关系，如果炎症，旁分泌介质解释这种关联。
Atrial fibrillation (AF) has been linked to inflammatory factors and obesity. Epicardial fat is a source of several inflammatory mediators related to the development of coronary artery disease. We hypothesized that periatrial fat may have a similar role in the development of AF. Left atrium (LA) epicardial fat pad thickness was measured in consecutive cardiac CT angiograms performed for coronary artery disease or AF. Patients were grouped by AF burden: no (n=73), paroxysmal (n=60), or persistent (n=36) AF. In a short-axis view at the mid LA, periatrial epicardial fat thickness was measured at the esophagus (LA-ESO), main pulmonary artery, and thoracic aorta; retrosternal fat was measured in axial view (right coronary ostium level). LA area was determined in the 4-chamber view. LA-ESO fat was thicker in patients with persistent AF versus paroxysmal AF (P=0.011) or no AF (P=0.003). LA area was larger in patients with persistent AF than paroxysmal AF (P=0.004) or without AF (P<0.001). LA-ESO was a significant predictor of AF burden even after adjusting for age, body mass index, and LA area (odds ratio, 5.30; 95% confidence interval, 1.39 to 20.24; P=0.015). A propensity score–adjusted multivariable logistic regression that included age, body mass index, LA area, and comorbidities was also performed and the relationship remained statistically significant (P=0.008). Increased posterior LA fat thickness appears to be associated with AF burden independent of age, body mass index, or LA area. Further studies are necessary to examine cause and effect, and if inflammatory, paracrine mediators explain this association.