Department of Radiology, Korea University Guro Hospital, Korea University of College of Medicine, Seoul, Korea.
J Cardiovasc Electrophysiol. 2011 Jun;22(6):647-55. doi: 10.1111/j.1540-8167.2010.01993.x. Epub 2011 Jan 15.
As epicardial adipose tissue (EAT) is a metabolically active visceral fat, potential interaction between EAT and myocardium is strongly suggested. The aims of this study were to determine whether the amount and regional distribution of EAT are related to the chronicity of atrial fibrillation (AF) and left atrial (LA) remodeling.
This study consisted of 40 subjects with paroxysmal AF (PAF) and 40 with persistent AF (PeAF). Eighty subjects with no history of AF were enrolled as controls. Total volume of EAT (EAT(total)), regional thickness of EAT, and LA volume (LAV) were measured by multislice computed tomography. In the AF group, blood samples were drawn from coronary sinus for analysis of inflammatory cytokines including adiponectin.
Compared with controls, AF subjects had larger LAV, EAT(total), and the thicknesses of periatrial EAT including interatrial septum (IAS). However, the thicknesses of periventricular EAT were not different between the groups. The PeAF subjects had larger LAV, EAT(total), and periatrial EAT thicknesses, higher levels of inflammatory cytokines, and lower level of adiponectin than did the PAF subjects. Adiponection level was significantly associated with EAT(total) and IAS thickness. Multivariate analysis revealed that EAT(total) (P = 0.004) and IAS thickness (P = 0.016) were independently associated with LAV.
EAT(total) and thickness of periatrial EAT were significantly larger in AF subjects compared to those of the matched controls and were closely related to the chronicity of AF. Moreover, EAT(total) and IAS thickness were independently associated with LAV in subjects with AF.
由于心外膜脂肪组织（EAT）是一种代谢活跃的内脏脂肪，因此强烈提示 EAT 与心肌之间存在潜在的相互作用。本研究旨在确定 EAT 的数量和区域分布是否与心房颤动（AF）的慢性和左心房（LA）重构有关。
本研究纳入了 40 例阵发性 AF（PAF）患者和 40 例持续性 AF（PeAF）患者。80 例无 AF 病史的患者作为对照组。通过多排螺旋 CT 测量 EAT 的总容积（EAT(total)）、EAT 各区域厚度和 LA 容积（LAV）。在 AF 组中，从冠状窦采血以分析包括脂联素在内的炎症细胞因子。
与对照组相比，AF 患者的 LAV、EAT(total)和包括房间隔在内的周围 EAT 厚度更大。然而，各组间心外膜周围 EAT 的厚度没有差异。PeAF 患者的 LAV、EAT(total)和周围 EAT 厚度较大，炎症细胞因子水平较高，脂联素水平较低，而 PAF 患者则相反。脂联素水平与 EAT(total)和房间隔厚度显著相关。多变量分析显示，EAT(total)（P=0.004）和房间隔厚度（P=0.016）与 LAV 独立相关。
与匹配的对照组相比，AF 患者的 EAT(total)和周围 EAT 厚度明显更大，且与 AF 的慢性程度密切相关。此外，EAT(total)和房间隔厚度与 AF 患者的 LAV 独立相关。
