Left atrial epicardial fat volume was significantly greater in AF patients (28.9 vs 14.2 mL) and independently associated with AF presence (OR 1.42; 95% CI 1.23%-1.62%; P<0.001).
Case-Control (n=105)
Does LA-epicardial fat volume measured by 3D Dixon CMR associate with atrial fibrillation and improve its detection compared to LA volume alone?
LA-epicardial fat volume measured by 3D Dixon CMR is significantly increased in AF patients and improves the detection of AF beyond LA structural remodeling alone.
Effect estimate: OR 1.42 (95% CI 1.23%-1.62%)
Absolute Event Rate: 28.9% vs 14.2%
p-value: p=<0.001
Background Recent studies demonstrated a strong association between atrial fibrillation ( AF ) and epicardial fat around the left atrium ( LA ). We sought to assess whether epicardial fat volume around the LA is associated with AF , and to determine the additive value of LA ‐epicardial fat measurements to LA structural remodeling for identifying patients with AF using 3‐dimensional multi‐echo Dixon fat–water separated cardiovascular magnetic resonance. Methods and Results A total of 105 subjects were studied: 53 patients with a history of AF and 52 age‐matched patients with other cardiovascular diseases but no history of AF . The 3‐dimensional multi‐echo Dixon fat‐water separated sequence was performed for LA ‐epicardial fat measurements. AF patients had significantly greater LA ‐epicardial fat (28.9±12.3 and 14.2±7.3 mL for AF and non‐ AF , respectively; P <0.001) and LA volume (110.8±38.2 and 89.7±30.3 mL for AF and non‐ AF , respectively; P =0.002). LA ‐epicardial fat adjusted for LA volume was still higher in patients with AF compared with those without AF ( P <0.001). LA ‐epicardial fat and hypertension were independently associated with the risk of AF (odds ratio, 1.17; 95% confidence interval, 1.10%–1.25%, P <0.001, and odds ratio, 3.29; 95% confidence interval, 1.17%–9.27%, P =0.03, respectively). In multivariable logistic regression analysis adjusted for body surface area, LA ‐epicardial fat remained significant and an increase per mL was associated with a 42% increase in the odds of AF presence (odds ratio, 1.42; 95% confidence interval, 1.23%–1.62%, P <0.001). Combined assessment of LA ‐epicardial fat and LA volume provided greater discriminatory performance for detecting AF than LA volume alone (c‐statistic=0.88 and 0.74, respectively, DeLong test; P <0.001). Conclusions Cardiovascular magnetic resonance 3‐dimensional Dixon‐based LA ‐epicardial fat volume is significantly increased in AF patients. LA ‐epicardial fat measured by 3‐dimensional Dixon provides greater performance for detecting AF beyond LA structural remodeling.
Nakamori et al. (Tue,) conducted a case-control in Atrial Fibrillation (n=105). LA-epicardial fat measurement via 3D multi-echo Dixon CMR vs. Non-AF patients was evaluated on Presence of atrial fibrillation (OR 1.42, 95% CI 1.23%-1.62%, p=<0.001). Left atrial epicardial fat volume was significantly greater in AF patients (28.9 vs 14.2 mL) and independently associated with AF presence (OR 1.42; 95% CI 1.23%-1.62%; P<0.001).
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