Key result
Imaging links cardiac adiposity to arrhythmogenesis but lacks proven additive value over standard risk algorithms.
Why the study?
Do imaging modalities assessing cardiac adiposity improve risk prediction for atrial fibrillation and ventricular arrhythmias?
Do imaging modalities assessing cardiac adiposity improve risk prediction for atrial fibrillation and ventricular arrhythmias?
While imaging of cardiac adiposity provides pathophysiological insights into arrhythmogenesis, its additive value to standard risk prediction algorithms remains insufficiently established for routine use.
Answers are grounded in this paper and cite their sources.
Cardiac adiposity imaging yields mechanistic insights without proven additive value; leaves open its utility beyond standard arrhythmia risk algorithms.
Increased cardiac fat depots are metabolically active tissues that have a pronounced pro-inflammatory nature. Increasing evidence supports a potential role of cardiac adiposity as a determinant of the substrate of atrial fibrillation and ventricular arrhythmias. The underlying mechanism appears to be multifactorial with local inflammation, fibrosis, adipocyte infiltration, electrical remodeling, autonomic nervous system modulation, oxidative stress and gene expression playing interrelating roles. Current imaging modalities, such as echocardiography, computed tomography and cardiac magnetic resonance, have provided valuable insight into the relationship between cardiac adiposity and arrhythmogenesis, in order to better understand the pathophysiology and improve risk prediction of the patients, over the presence of obesity and traditional risk factors. However, at present, given the insufficient data for the additive value of imaging biomarkers on commonly used risk algorithms, the use of different screening modalities currently is indicated for personalized risk stratification and prognostication in this setting.
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Bonou et al. (2021) conducted a review in Cardiac adiposity and arrhythmias. Imaging modalities (echocardiography, computed tomography, cardiac magnetic resonance) was evaluated. Imaging modalities provide valuable insight into the relationship between cardiac adiposity and arrhythmogenesis, though data on their additive value to standard risk algorithms remains insufficient.
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