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Heart and Vessels

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01-08-2020 | Atrial Fibrillation | Original Article

Difference in epicardial adipose tissue distribution between paroxysmal atrial fibrillation and coronary artery disease

Authors: Hideyuki Hasebe, Kentaro Yoshida, Akihiko Nogami, Masaki Ieda

Published in: Heart and Vessels | Issue 8/2020

Abstract

Background

An increase in epicardial adipose tissue (EAT) volume is associated with the development of atrial fibrillation (AF) and coronary artery disease (CAD), but little is known about differences in its distribution.

Methods and results

We included 50 patients with paroxysmal AF (PAF), 50 patients with CAD, and 50 control patients. Using multidetector computed tomography, EAT volumes surrounding the whole heart (total EAT), the atrium (atrial-EAT), and the ventricle (ventricular-EAT) were measured. EAT atrial/ventricular (A/V) ratio was calculated by dividing atrial- by ventricular-EAT volume. The total EAT volume indexes in the PAF and CAD groups were significantly larger than those in the control group. The atrial-EAT volume index in the PAF group was significantly larger than that in the CAD and control groups, whereas the ventricular-EAT volume index in the CAD group was significantly larger than that in the PAF and control groups. Thus, EAT A/V ratio was smaller in the CAD and control group than that in the PAF group (0.28 ± 0.12 vs. 0.38 ± 0.13 vs. 0.54 ± 0.33, P < .001). Univariate and multivariate linear regression analysis showed EAT A/V ratio to be independently associated with cardiovascular disease type (PAF vs. CAD; P < .001, β = .463).

Conclusions

Atrial- and ventricular-dominant distribution of EAT was observed in the PAF and CAD groups, respectively. Uneven distribution of EAT may imply the direct contribution of EAT-related inflammation to the pathogenesis of AF or CAD.

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Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, Sarov-Blat L, O’Brien S, Keiper EA, Johnson AG, Martin J, Goldstein BJ, Shi Y (2003) Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 108:2460–2466CrossRef

Cherian S, Lopaschuk GD, Carvalho E (2012) Cellular cross-talk between epicardial adipose tissue and myocardium in relation to the pathogenesis of cardiovascular disease. Am J Physiol Endocrinol Metab 303:E937–E949CrossRef

Thanassoulis G, Massaro JM, O’Donnell CJ, Hoffmann U, Levy D, Ellinor PT, Wang TJ, Schnabel RB, Vasan RS, Fox CS, Benjamin EJ (2010) Pericardial fat is associated with prevalent atrial fibrillation: the Framingham Heart Study. Circ Arrhythm Electrophysiol 3:345–350CrossRef

Hatem SN, Sanders P (2014) Epicardial adipose tissue and atrial fibrillation. Cardiovasc Res 102:205–213CrossRef

van Rosendael AR, Dimitriu-Leen AC, van Rosendael PJ, Leung M, Smit JM, Saraste A, Knuuti J, van der Greest RJ, van der Arend BW, van Zwet EW, Scholte AJ, Delgado V, Bax JJ (2017) Association between posterior left atrial adipose tissue mass and atrial fibrillation. Circ Arrhythm Electrophysiol 10:e004614PubMed

Nakanishi K, Fukuda S, Tanaka A, Otsuka K, Sakamoto M, Taguchi H, Yoshikawa J, Shimada K, Yoshiyama M (2012) Peri-atrial epicardial adipose tissue is associated with new-onset nonvalvular atrial fibrillation. Circ J 76:2748–2754CrossRef

Greif M, von Ziegler F, Wakili R, Tittus J, Becker C, Helbig S, Laubender RP, Schwarz W, D’Anastasi M, Schenzle J, Leber AW, Becker A (2013) Increased pericardial adipose tissue is correlated with atrial fibrillation and left atrial dilatation. Clin Res Cardiol 102:555–562CrossRef

Kocyigit D, Gurses KM, Yalcin MU, Turk G, Euranos B, Yorgun H, Sahiner ML, Kaya EB, Hazirolan T, Tokgozoglu L, Oto MA, Ozer N, Aytemir K (2015) Periatrial epicardial adipose tissue thickness is an independent predictor of atrial fibrillation recurrence after cryoballoon-based pulmonary vein isolation. J Cardiovasc Comput Tomogr 9:295–302CrossRef

Ito T, Nasu K, Terashima M, Ehara M, Kinoshita Y, Ito T, Kimura M, Tanaka N, Habara M, Tsuchikane E, Suzuki T (2012) The impact of epicardial fat volume on coronary plaque vulnerability: insight from optical coherence tomography analysis. Eur Heart J Cardiovasc Imaging 13:408–415CrossRef

10.

Mahabadi AA, Lehmann N, Kälsch H, Robens T, Bauer M, Dykun I, Budde T, Moebus S, Jöckel KH, Erbel R, Möhlenkamp S (2014) Association of epicardial adipose tissue with progression of coronary artery calcification is more pronounced in the early phase of atherosclerosis: results from the Heinz Nixdorf recall study. JACC Cardiovasc Imaging 7:909–916CrossRef

11.

Hirata Y, Tabata M, Kurobe H, Motoki T, Akaike M, Nishio C, Higashida M, Mikasa H, Nakaya Y, Takanashi S, Igarashi T, Kitagawa T, Sata M (2011) Coronary atherosclerosis is associated with macrophage polarization in epicardial adipose tissue. J Am Coll Cardiol 58:248–255CrossRef

12.

Mahabadi AA, Berg MH, Lehmann N, Kälsch H, Bauer M, Kara K, Dragano N, Moebus S, Jöckel KH, Erbel R, Möhlenkamp S (2013) Association of epicardial fat with cardiovascular risk factors and incident myocardial infarction in the general population: the Heinz Nixdorf Recall Study. J Am Coll Cardiol 61:1388–1395CrossRef

13.

Senoo A, Kitagawa T, Torimaki S, Yamamoto H, Sentani K, Takahashi S, Kubo Y, Yasui W, Kihara Y (2018) Association between histological features of epicardial adipose tissue and coronary plaque characteristics on computed tomography angiography. Heart Vessels 33:827–836CrossRef

14.

Kim MN, Kim HL, Park SM, Shin MS, Yu CW, Kim MA, Houg KS, Shim WJ (2018) Association of epicardial adipose tissue with coronary spasm and coronary atherosclerosis in patients with chest pain: analysis of data collected by the KoRean wOmen’S chest pain rEgistry (koROSE). Heart Vessels 33:17–24CrossRef

15.

Soucek F, Covassin N, Singh P, Ruzek L, Kara T, Suleiman M, Lerman A, Koestler C, Friedman PA, Lopez-Jimenez F, Somers VK (2015) Effects of atorvastatin (80 mg) therapy on quantity of epicardial adipose tissue in patients undergoing pulmonary vein isolation for atrial fibrillation. Am J Cardiol 116:1443–1446CrossRef

16.

Zghaib T, Ipek EG, Zahid S, Balouch MA, Misra S, Ashikaga H, Berger RD, Marine JE, Spragg DD, Zimmerman SL, Zipunnikov V, Trayanova N, Calkins H, Nazarian S (2016) Association of left atrial epicardial adipose tissue with electrogram bipolar voltage and fractionation: electrophysiologic substrates for atrial fibrillation. Heart Rhythm 13:2333–2339CrossRef

17.

Wong CX, Abed HS, Molaee P, Nelson AJ, Brooks AG, Sharma G, Leong DP, Lau DH, Middeldorp ME, Roberts-Thomson KC, Wittert GA, Abhayaratna WP, Worthley SG, Sanders P (2011) Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol 57:1745–1751CrossRef

18.

Nakahara S, Hori Y, Kobayashi S, Sakai Y, Taguchi I, Takayanagi K, Nagashima K, Sonoda K, Kogawa R, Sasaki N, Watanabe I, Okumura Y (2014) Epicardial adipose tissue-based defragmentation approach to persistent atrial fibrillation: its impact on complex fractionated electrograms and ablation outcome. Heart Rhythm 11:1343–1351CrossRef

19.

Mahabadi AA, Reinsch N, Lehmann N, Altenbernd J, Kälsch H, Seibel RM, Erbel R, Möhlenkamp S (2010) Association of pericoronary artery fat volume with atherosclerotic plaque burden in the underlying coronary artery: a segment analysis. Atherosclerosis 211:195–199CrossRef

20.

Ansaldo AA, Montecucco F, Sahebkar A, Dallegri F, Carbone F (2019) Epicardial adipose tissue and cardiovascular disease. Int J Cardiol 278:254–260CrossRef

21.

Ishikawa Y, Akasaka Y, Suzuki K, Fujiwara M, Ogawa T, Yamazaki K, Niino H, Tanaka M, Ogata K, Morinaga S, Ebihara Y, Kawahara Y, Sugiura H, Takimoto T, Komatsu A, Shinagawa T, Taki K, Satoh H, Yamada K, Yanagida-Iida M, Shimokawa R, Shimada K, Nishimura C, Ito K, Ishii T (2009) Anatomic properties of myocardial bridge predisposing to myocardial infection. Circulation 120:376–383CrossRef

22.

Zeina AR, Odeh M, Blinder J, Rosenschein U, Barmeir E (2007) Myocardial bridge: evaluation on MDCT. Am J Roentgenol 188:1069–1073CrossRef

23.

Renovato-Martins M, Matheus ME, de Andrade IR, Moraes JA, da Silva SV, Citelli Dos Reis M, de Souza AA, da Silva CC, Bouskela E, Barja-Fidalgo C (2017) Microparticles derived from obese adipose tissue elicit a pro-inflammatory phenotype of CD16⁺, CCR5⁺ and TLR8⁺ monocytes. Biochem Biophys Acta Basis Dis 1863:139–151

24.

Li C, Li S, Zhang F, Wu M, Liang H, Song J, Lee C, Chen H (2018) Endothelial microparticles-mediated transfer of microRNA-19b promotes atherosclerosis via activating perivascular adipose tissue inflammation in apoE⁻^/⁻ mice. Biochem Biophys Res Commun 495:1922–1929CrossRef

25.

Alexopoulos N, Melek BH, Arepalli CD, Hartlage GR, Chen Z, Kim S, Stillman AE, Raggi P (2013) Effect of intensive versus moderate lipid-lowering therapy on epicardial adipose tissue in hyperlipidemic post-menopausal woman: a substudy of the BELLES trial (Beyond Endorsed Lipid Lowering with EBT Scanning). J Am Coll Cardiol 61:1956–1961CrossRef

Title: Difference in epicardial adipose tissue distribution between paroxysmal atrial fibrillation and coronary artery disease
Authors: Hideyuki Hasebe
Kentaro Yoshida
Akihiko Nogami
Masaki Ieda
Publication date: 01-08-2020
Publisher: Springer Japan
Keywords: Atrial Fibrillation
Arterial Diseases
Published in: Heart and Vessels / Issue 8/2020
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-020-01575-3

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