Greater epicardial adipose thickness was independently associated with worse atrial function and improved reclassification for atrial fibrillation incidence (p<0.05), mainly in non-obese phenotypes.
Cohort (n=2,944)
Does epicardial adipose thickness and obesity phenotype correlate with atrio-ventricular dysfunction and incident atrial fibrillation in symptom-free individuals?
Excessive visceral adiposity, measured by epicardial fat, is associated with atrial dysfunction and incident atrial fibrillation, particularly in non-obese individuals.
p-value: p=< 0.05
Obesity has been conceptualized as a highly heterogeneous condition. We aim to investigate chamber-specific effects of obesity on the heart and relevant outcomes. A total of 2944 symptom-free individuals (age: 47.5 ± 10.0 years), free of known cardiovascular diseases were classified into four categories based on body mass index (BMI) (as normal-weight (NW) vs. overweight/obese (O)) and metabolic status (metabolically-healthy (MH) vs. unhealthy (MU)). Epicardial adipose thickness (EAT) using echocardiography method. Speckle-tracking based atrio-ventricular (LA/LV) deformations including global longitudinal strain (GLS) and peak atrial longitudinal strain (PALS) were also analyzed. MUNW had higher cardiometabolic risks and more impaired diastolic and GLS/PALS than MHNW phenotype. Both MHO and MUO phenotypes exhibited worst atrial functions. Greater EAT was independently associated with worse GLS and PALS after correcting for various anthropometrics, LV mass and LA volume, respectively, with unfavorable LA effects from EAT being more pronounced in the NW phenotypes (both p interactions < 0.05). During a median follow-up period of 5.3 years, BMI/EAT improved the reclassification for atrial fibrillation (AF) incidence (p for net reclassification improvement < 0.05) mainly in the NW phenotypes (p interaction < 0.001). Categorization of clinical obesity phenotypes based on excessive visceral adiposity likely provides increment prognostic impacts on atrial dysfunction, particularly in non-obese phenotypes.
Lai et al. (Sat,) conducted a cohort in Obesity (n=2,944). Epicardial adipose thickness (EAT) and obesity phenotypes vs. Metabolically-healthy normal-weight phenotype was evaluated on Atrial fibrillation (AF) incidence (p=< 0.05). Greater epicardial adipose thickness was independently associated with worse atrial function and improved reclassification for atrial fibrillation incidence (p<0.05), mainly in non-obese phenotypes.
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