Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
February 6, 2026European Heart Journal

The impact of atrial fibrillation progression on the epicardial adipose tissue volume: supporting 'AF begets EAT' theory

View Full Paper
Ask AI
Bookmark
Share

Key result

Non-paroxysmal AF is linked to ~21% greater total epicardial adipose tissue volume than paroxysmal AF.

  • P<0.001
  • n=1,321

Why the study?

While epicardial adipose tissue is known to contribute to AF onset, whether AF progression conversely drives epicardial adipose tissue volume expansion remained unclear.

Is atrial fibrillation progression associated with increased epicardial adipose tissue volume?

Population

1,321 patients with paroxysmal, early-persistent, persistent, or longstanding-persistent AF

Comparison

Patients across different stages of AF progression and AF durations

Design

Single-center retrospective observational study

Authors

KSKazuki ShimojoIMI MorishimaYMY Morita

Discussion

Loading...

Member takes

Overview

AF progression linked to larger EAT volume in this cohort; extends observational data but leaves causal direction and clinical implications open.

Key Points

  • This study investigates the relationship between epicardial adipose tissue volume and the progression of atrial fibrillation.
  • Retrospective analysis of patients with paroxysmal, early-persistent, persistent, and longstanding-persistent AF.
  • EAT volume quantified via 3D imaging from contrast-enhanced CT images.
  • Identified correlates of EAT volume using multiple regression analysis.
  • Non-paroxysmal AF patients had significantly larger EAT volumes compared to paroxysmal AF patients.
  • Total and LA EAT volumes increased proportionally with AF burden in the paroxysmal group.
  • AF type and duration, along with age, BMI, HDL-C, and HbA1c, were significant factors associated with EAT volumes.

Study Design

Type

Observational (n=1,321)

Multicenter

No

Structured PICO

Is atrial fibrillation progression associated with increased epicardial adipose tissue volume?

P
Population
1,321 patients with paroxysmal AF (n=721), early-persistent AF (n=266), persistent AF (n=239), and longstanding-persistent AF (n=95), mean age 69.0±9.9 years, 69.7% male.
C
Comparator
Paroxysmal AF (PAF) compared to non-PAF (early-persistent, persistent, and longstanding-persistent AF)
O
Outcome
Epicardial adipose tissue volume (Total-EATV and LA-EATV) quantified using contrast-enhanced computed tomographysurrogate

Main Result

Absolute Event Rate: 152.3% vs 125.9%

p-value: p=<0.001

Atrial fibrillation progression is associated with an increase in epicardial adipose tissue volume, supporting the 'AF begets EAT' theory and highlighting the potential benefit of early intervention.

Cite This Study

Shimojo et al. (2025) conducted an observational in Atrial fibrillation (n=1,321). Non-paroxysmal atrial fibrillation vs. Paroxysmal atrial fibrillation was evaluated on Total epicardial adipose tissue volume (Total-EATV) in mL (p=<0.001). Non-paroxysmal atrial fibrillation was associated with significantly larger total epicardial adipose tissue volume compared to paroxysmal AF (152.3 mL vs 125.9 mL; p<0.001).

synapsesocial.com/papers/698586388f7c464f2300a3cahttps://doi.org/10.1093/eurheartj/ehaf784.711
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Role of epicardial adipose tissue in the development of atrial fibrillation in hypertensive patients2020 · 9 citations
  2. 2Effect of the Epicardial Adipose Tissue Volume on the Prevalence of Paroxysmal and Persistent Atrial Fibrillation2018 · 43 citations
  3. 3Epicardial adipose tissue and atrial fibrillation: guilty as charged or guilty by association?2020 · 2 citations
  4. 4Total and Interatrial Epicardial Adipose Tissues Are Independently Associated With Left Atrial Remodeling in Patients With Atrial Fibrillation2011 · 139 citations
  5. 5Associations between atrial epicardial fat quantified by semi-automated CT segmentation and gender, BMI, cholesterol levels in AF patients: results from the prospective AFAT study2024