Infiltrated atrial fat characterizes underlying atrial fibrillation substrate in patients at risk as defined by the ARIC atrial fibrillation risk score

Larisa G. Tereshchenko, Patricia Rizzi, Nathan Mewton, Gustavo Jardim Volpe, Sindhoora Murthy, David G. Strauss, Chia Y. Liu, Francis E. Marchlinski, Peter Spooner, Ronald D. Berger, Peter Kellman, Joao A.C. Lima

    Research output: Contribution to journalArticle

    16 Scopus citations

    Abstract

    Background It is known that expanded epicardial fat is associated with atrial fibrillation (AF). However, infiltrated intraatrial fat has not been previously quantified in individuals at risk as determined by the ARIC AF risk score. Methods Patients in sinus rhythm (N = 90, age 57 ± 10 years; 55 men [63.2%]), in 3 groups at risk of AF as determined by the ARIC AF risk score [low (≤ 11 points; n = 15), moderate (12-18 points; n = 40), high (≥ 19 points; n = 23) risk of AF], and paroxysmal AF (n = 12) underwent cardiac magnetic resonance study. Intraatrial and epicardial fat was analyzed with a Dark-blood DIR-prepared Fat-Water-separated sequence in the horizontal longitudinal axis. OsiriX DICOM viewer (Geneva, Switzerland) was used to quantify the intraatrial fat area. Width of the cephalad portion of the interatrial septum was measured at the level of the fossa ovalis. Results Intraatrial fat monotonically increased with growing AF risk in study groups (low AF risk 16 ± 4 vs. moderate AF risk 32 ± 18 vs. high AF risk 81 ± 83 mm2; ANOVA P = 0.012). Log-transformed intraatrial fat predicted ARIC AF risk score in multivariate ordered probit regression after adjustment for sex, race, left and right atrial area indices, and body mass index (β-coefficient 0.50 [95% CI 0.03-0.97]; P = 0.037), whereas epicardial fat did not. Interatrial septum width showed similar association (3.0 ± 1.4 vs. 5.0 ± 1.8 vs. 7.1 ± 2.7 mm; ANOVA P < 0.001; adjusted β-coefficient 2.80 [95% CI 1.19-4.41]; P = 0.001). Conclusions Infiltrated intraatrial fat characterizes evolving substrate in individuals at risk of AF.

    Original languageEnglish (US)
    Pages (from-to)196-201
    Number of pages6
    JournalInternational Journal of Cardiology
    Volume172
    Issue number1
    DOIs
    StatePublished - Mar 1 2014

    Keywords

    • Atrial fibrillation
    • Cardiac magnetic resonance
    • Intraatrial infiltrated fat
    • Risk score

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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  • Cite this

    Tereshchenko, L. G., Rizzi, P., Mewton, N., Volpe, G. J., Murthy, S., Strauss, D. G., Liu, C. Y., Marchlinski, F. E., Spooner, P., Berger, R. D., Kellman, P., & Lima, J. A. C. (2014). Infiltrated atrial fat characterizes underlying atrial fibrillation substrate in patients at risk as defined by the ARIC atrial fibrillation risk score. International Journal of Cardiology, 172(1), 196-201. https://doi.org/10.1016/j.ijcard.2014.01.012