Increased epicardial fat tissue thickness predicts advanced interatrial block among hypertensive patients

Recent studies demonstrated that epicardial fat tissue (EFT) was associated with prevalent AF and recurrences following the catheter ablation. We evaluated the value of EFT for the prediction of advanced interatrial block (a-IAB) in the surface electrocardiography (ECG) among hypertensive patients.

Patients with prior diagnosis of hypertension (HT) were included in the study. Surface ECG and transthoracic echocardiography (TTE) were performed to each patient. A-IAB was defined as P-wave duration longer than 120 ms with biphasic morphology in the inferior leads. EFT was identified by using TTE and was measured perpendicularly in front of the right ventricular free wall at the end-systole.

Between February 2019 and February 2020 245 patients met the eligibility criteria. A-IAB was found among 35 patients and compared to those without IAB, they had increased waist circumference, elevated left ventricular mass index (LVMI) and left atrial volume index (LAVI), lower LDL and increased P wave duration. EFT thickness was higher in patients with a-IAB compared to those without (5.3 ± 2.2 mm vs 7.6 ± 2.4 mm). Multivariable analysis revealed that increased EFT thickness and lower LDL level predicted a-IAB.

Among patients with prior diagnosis of HT, higher EFT thickness evaluated by TTE predicted the presence of a-IAB on the surface ECG.