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Epicardial fat in atrial fibrillation and heart failure

G Iacobellis1, M C Zaki2, D Garcia3

  • 1Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Miami, Miller School of Medicine, Miami, FL, USA.

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|February 22, 2014
PubMed

Insights

Epicardial fat thickness, measured by ultrasound, is higher in patients with permanent atrial fibrillation (AF) compared to paroxysmal AF (PAF). This finding suggests a link between epicardial fat and chronic AF development.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Obesity Research

Background:

  • Obesity is a known risk factor for atrial fibrillation (AF) and heart failure (HF).
  • Epicardial fat, the heart's visceral fat depot, influences cardiac function and morphology.
  • The relationship between epicardial fat thickness and AF/HF requires further investigation.

Purpose of the Study:

  • To evaluate the association between ultrasound-measured epicardial fat thickness and the presence of AF and HF.
  • To compare epicardial fat thickness in patients with permanent AF versus paroxysmal AF (PAF).
  • To examine epicardial fat thickness in relation to heart failure status.

Main Methods:

  • A cross-sectional study involving 84 subjects with documented AF (permanent or PAF).
  • Echocardiographic measurement of epicardial fat thickness.
  • Comparison of epicardial fat thickness between AF and PAF groups, and between subjects with and without HF (defined by ejection fraction <50%).

Main Results:

  • Subjects with AF exhibited higher epicardial fat thickness (4.8±2.5 mm) compared to those with PAF (3.5±2.4 mm; p<0.05).
  • Patients with AF had a higher prevalence of heart failure (HF) than those with PAF (p<0.01).
  • Epicardial fat thickness was lower in subjects with HF (4.4±2.2 mm) compared to those without HF (5.4±2.3 mm; p<0.05).

Conclusions:

  • Echocardiographic epicardial fat thickness is significantly higher in chronic AF patients than in PAF patients.
  • This suggests a potential long-term influence of epicardial fat on the development of permanent AF.
  • Reduced epicardial fat in HF patients may reflect overall fat reduction or fibrotic changes in the epicardial fat pad.

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