Zhu Jingqi, Yang Zhangwei, Chen Xiaoli, Liu Jie, Zheng Liang, Zhang Lin, Pi Jingjiang, Li Gang, Zhuang Tao, Liu Chang, Wang Yinglu, Liu Liping, Fan Lieying, Chan Paul, Tomlinson Brian, Li Ying, Liu Zhongmin, Zhang Yuzhen
Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Mar 18;14:1223-1232. doi: 10.2147/DMSO.S274047. eCollection 2021.
An association of atrial fibrillation (AF) with epicardial fat volume (EFV) varied in different ethnic groups. We evaluated the AF-related risk factors and its association with pericardial fat in Chinese patients.
Patients referred for coronary computed tomography angiography (CCTA) in Shanghai East Hospital during 2012 to 2014 (n=2042, 43.8% women, mean age 65.0 years) had AF and cardiovascular risk assessment. Pericardial fat depots were measured from CT and the association of EFV with non-valvular AF risk factors was evaluated by multivariate logistic regression models.
AF was present in 8.5% of patients with 11.6% of AF patients having rheumatic heart disease (RHD) and 8.7% having other valvular diseases. With increasing age, the proportion of RHD-related AF decreased and the risk factors for non-valvular AF increased. There was a significantly higher proportion of risk factors for non-valvular AF in men than in women (p=0.008), but RHD-related AF was more prevalent in women than men (p=0.013). The patients with non-valvular AF had significantly higher BMI and EFV with more pronounced elevation of EFV (p<0.001). Multivariate logistic regression showed a significant association of EFV with AF after adjustment for BMI and clinical risk factors, and the highest EFV quartile was associated with AF independent of left atrial size and obstructive coronary artery disease.
The association of EFV with non-valvular AF in Chinese patients was independent of generalized adiposity and clinical risk factors especially in highest EFV quartile. These findings support the growing appreciation of the association of EFV with AF.
心房颤动（AF）与心外膜脂肪体积（EFV）的关联在不同种族群体中有所不同。我们评估了中国患者中与AF相关的危险因素及其与心包脂肪的关联。
2012年至2014年期间在上海东方医院接受冠状动脉计算机断层扫描血管造影（CCTA）检查的患者（n = 2042，女性占43.8%，平均年龄65.0岁）进行了AF和心血管风险评估。通过CT测量心包脂肪储存，并通过多变量逻辑回归模型评估EFV与非瓣膜性AF危险因素的关联。
8.5%的患者存在AF，其中11.6%的AF患者患有风湿性心脏病（RHD），8.7%患有其他瓣膜疾病。随着年龄的增长，RHD相关AF的比例下降，非瓣膜性AF的危险因素增加。男性中非瓣膜性AF危险因素的比例显著高于女性（p = 0.008），但RHD相关AF在女性中比男性更普遍（p = 0.013）。非瓣膜性AF患者的BMI和EFV显著更高，EFV升高更为明显（p < 0.001）。多变量逻辑回归显示，在调整BMI和临床危险因素后，EFV与AF存在显著关联，并且最高EFV四分位数与AF相关，独立于左心房大小和阻塞性冠状动脉疾病。
在中国患者中，EFV与非瓣膜性AF的关联独立于全身性肥胖和临床危险因素，尤其是在最高EFV四分位数中。这些发现支持了对EFV与AF关联的日益重视。
