Key result
Epicardial adipose tissue and its associated local inflammatory processes are recognized as major independent risk factors in the pathogenesis and maintenance of atrial fibrillation.
Why the study?
The aetiology of atrial fibrillation remains poorly understood despite its growing prevalence and morbidity, prompting exploration into the roles of obesity, epicardial adipose tissue, and inflammation in its pathogenesis.
This review highlights the mechanistic role of epicardial adipose tissue and local inflammation in the pathogenesis and maintenance of atrial fibrillation, suggesting potential new avenues for clinical management.
EAT may refine AF risk assessment in obesity; leaves open whether targeting it alters outcomes.
The aetiology of atrial fibrillation (AF) remains poorly understood, despite its growing prevalence and associated morbidity, mortality, and healthcare costs. Obesity is implicated in myriad different disease processes and is now recognized a major risk factor in the pathogenesis of AF. Moreover, the role of distinct adipose tissue depots is a matter of intense scientific interest with the depot directly surrounding the heart-epicardial adipose tissue (EAT) appearing to have the greatest correlation with AF presence and severity. Similarly, inflammation is implicated in the pathophysiology of AF with EAT thought to act as a local depot of inflammatory mediators. These can easily diffuse into atrial tissue with the potential to alter its structural and electrical properties. Various meta-analyses have indicated that EAT size is an independent risk factor for AF with adipose tissue expansion being inevitably associated with a local inflammatory process. Here, we first briefly review adipose tissue anatomy and physiology then move on to the epidemiological data correlating EAT, inflammation, and AF. We focus particularly on discussing the mechanistic basis of how EAT inflammation may precipitate and maintain AF. Finally, we review how EAT can be utilized to help in the clinical management of AF patients and discuss future avenues for research.
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Vyas et al. (2020) conducted a review in Atrial fibrillation. Epicardial adipose tissue (EAT) and inflammation was evaluated. Epicardial adipose tissue and its associated local inflammatory processes are recognized as major independent risk factors in the pathogenesis and maintenance of atrial fibrillation.
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