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Epicardial adipose tissue volume by cardiac magnetic resonance imaging predicts abnormal myocardial relaxation in patients with atrial fibrillation
© Fernando et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Cardiac Magnetic Resonance
- Filling Pressure
- Epicardial Adipose Tissue
- Eventual Heart Failure
- Epicardial Adipose Tissue Volume
Inflammation may be a key trigger in the accumulation of extracellular matrix that leads to fibrosis, abnormal myocardial relaxation, diastolic dysfunction and eventual heart failure with a preserved ejection fraction (HFpEF). Epicardial adipose tissue (EAT) is a metabolically active organ releasing various adipokines and inflammatory mediators which may promote fibrosis in adjacent myocardium altering the structural properties of the ventricle leading to abnormal diastology. The aim of this study was to assess the relationship of EAT volume using cardiac magnetic resonance imaging (CMR) and parameters of diastolic dysfunction as assessed by 2D-transthoracic echocardiography (TTE) in patients with atrial fibrillation (AF).
Baseline patient characteristics
Obstructive sleep apnea
Paroxysmal atrial fibrillation
Body mass index (kg/m2)
28.6 +/- 5
Body surface area (m2)
2.06 +/- 0.23
TTE: Myocardial relaxation index (septal e')
8.14 +/- 2.29
TTE: Left ventricular filling pressures (E/e')
10.75 +/- 3.13
CMR: Left atrial volume (mL)
CMR: Left atrial volume index (mL/m2)
51.98 +/- 14.71
CMR: Epicardial adipose tissue volume (mL)
125.7 +/- 56.7
CMR:Left ventricular ejection fraction
60.93 +/- 4.81
Patients with elevated filling pressures (E/e' >15) had significantly higher EAT compared to those with normal filling pressures (E/e' <15) (164ml±118 vs 114ml±54, p<0.001). By univariate analysis, EAT volume had a significant inverse correlation with e' sep (r =-0.48, p=0.02), but not hypertension (r=0.25, p=0.09), or E/e' (r = 0.22, p=0.21). EAT volume remained the only significant predictor of abnormal myocardial relaxation in a multivariate linear regression model incorporating age, BMI, LA volume, hypertension and coronary artery disease (p = 0.04).
EAT volume quantified by CMR is independently associated with abnormal myocardial relaxation in patients with AF. EAT may serve as a novel therapeutic target to preserve diastolic function.
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