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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Relation of Pericardial Fat, Intrathoracic Fat, and Abdominal Visceral Fat With Incident Atrial Fibrillation (from

Jane J Lee1, Xiaoyan Yin2, Udo Hoffmann3

  • 1Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and, Blood Institute's and Boston University's Framingham Heart Study, Framingham, Massachusetts.

The American Journal of Cardiology
|September 27, 2016
PubMed

Insights

Obesity increases atrial fibrillation (AF) risk. While pericardial and intrathoracic fat were linked to AF, this association disappeared after accounting for body mass index, suggesting shared risk factors.

Area of Science:

  • Cardiology
  • Epidemiology
  • Radiology

Background:

  • Obesity is a known risk factor for atrial fibrillation (AF).
  • Different fat distribution patterns, including pericardial, intrathoracic, and visceral fat, may differentially impact cardiac health.
  • Understanding these associations is crucial for predicting and preventing AF.

Purpose of the Study:

  • To investigate the longitudinal associations between specific ectopic fat depots (pericardial, intrathoracic, visceral) and the incidence of atrial fibrillation (AF).
  • To determine if these fat depots are independent risk factors for AF, even after adjusting for overall obesity measures like body mass index (BMI).

Main Methods:

  • Utilized data from the Framingham Heart Study Offspring and Third-Generation Cohorts.
  • Employed multidetector computed tomography (MDCT) to quantify pericardial, intrathoracic, and abdominal visceral fat volumes.
  • Applied multivariable-adjusted Cox proportional hazard models to assess the risk of incident AF over a median follow-up of 9.7 years.

Main Results:

  • Higher volumes of pericardial and intrathoracic fat were initially associated with an increased risk of incident AF in age- and gender-adjusted models.
  • After multivariable adjustment, including BMI, these associations between pericardial, intrathoracic, and visceral fat and incident AF were no longer statistically significant.
  • This suggests that the observed links between cardiac fat depots and AF may be mediated by shared underlying risk factors, such as overall adiposity.

Conclusions:

  • While pericardial and intrathoracic fat may be associated with AF risk, this relationship appears to be confounded by overall body mass index.
  • Ectopic cardiac fat depots and AF likely share common underlying risk factors.
  • Further research is needed to elucidate the complex interplay between obesity, fat distribution, and atrial fibrillation development.

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