Relationship Between Epicardial Adipose Tissue and Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction.

INTRODUCTION AND AIM

Heart failure with preserved ejection fraction (HFpEF) is a significant clinical challenge, often coexisting with atrial fibrillation (AF), which exacerbates patient outcomes by increasing risks of stroke, hospitalizations, and mortality. Recent studies suggest that epicardial adipose tissue (EAT), a metabolically active fat depot, may contribute to AF pathogenesis by promoting atrial remodeling and fibrosis. This study aimed to evaluate the relationship between EAT thickness and AF in HFpEF patients.

MATERIALS AND METHODS

A total of 110 HFpEF patients were included, with 20 (18.2%) having documented AF. EAT thickness was measured using transthoracic echocardiography, and AF was confirmed via electrocardiography.

RESULTS

Patients with AF had significantly greater EAT thickness compared to those without AF (8.3 ± 0.9 mm vs. 7.1 ± 0.8 mm, p < 0.001). Receiver operating characteristic (ROC) analysis demonstrated that EAT thickness was a strong predictor of AF (AUC = 0.87, p < 0.001), with a cut-off value of 7.5 mm achieving 89% sensitivity and 75% specificity.

CONCLUSION

These findings indicate that increased EAT thickness is independently associated with AF in HFpEF patients, highlighting its potential as a biomarker for AF risk stratification. Future studies should explore whether targeting EAT could improve clinical outcomes in this high-risk population.