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

Larisa 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

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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
Externally publishedYes

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Atrial Fibrillation
Fats
Analysis of Variance
Switzerland
Body Mass Index
Magnetic Resonance Spectroscopy
Water

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Infiltrated atrial fat characterizes underlying atrial fibrillation substrate in patients at risk as defined by the ARIC atrial fibrillation risk score. / Tereshchenko, Larisa; Rizzi, Patricia; Mewton, Nathan; Volpe, Gustavo Jardim; Murthy, Sindhoora; Strauss, David G.; Liu, Chia Y.; Marchlinski, Francis E.; Spooner, Peter; Berger, Ronald D.; Kellman, Peter; Lima, Joao A C.

In: International Journal of Cardiology, Vol. 172, No. 1, 01.03.2014, p. 196-201.

Research output: Contribution to journalArticle

Tereshchenko, L, Rizzi, P, Mewton, N, Volpe, GJ, Murthy, S, Strauss, DG, Liu, CY, Marchlinski, FE, Spooner, P, Berger, RD, Kellman, P & Lima, JAC 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, vol. 172, no. 1, pp. 196-201. https://doi.org/10.1016/j.ijcard.2014.01.012
Tereshchenko, Larisa ; Rizzi, Patricia ; Mewton, Nathan ; Volpe, Gustavo Jardim ; Murthy, Sindhoora ; Strauss, David G. ; Liu, Chia Y. ; Marchlinski, Francis E. ; Spooner, Peter ; Berger, Ronald D. ; Kellman, Peter ; Lima, Joao A C. / Infiltrated atrial fat characterizes underlying atrial fibrillation substrate in patients at risk as defined by the ARIC atrial fibrillation risk score. In: International Journal of Cardiology. 2014 ; Vol. 172, No. 1. pp. 196-201.
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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.",
keywords = "Atrial fibrillation, Cardiac magnetic resonance, Intraatrial infiltrated fat, Risk score",
author = "Larisa Tereshchenko and Patricia Rizzi and Nathan Mewton and Volpe, {Gustavo Jardim} and Sindhoora Murthy and Strauss, {David G.} and Liu, {Chia Y.} and Marchlinski, {Francis E.} and Peter Spooner and Berger, {Ronald D.} and Peter Kellman and Lima, {Joao A C}",
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T1 - Infiltrated atrial fat characterizes underlying atrial fibrillation substrate in patients at risk as defined by the ARIC atrial fibrillation risk score

AU - Tereshchenko, Larisa

AU - Rizzi, Patricia

AU - Mewton, Nathan

AU - Volpe, Gustavo Jardim

AU - Murthy, Sindhoora

AU - Strauss, David G.

AU - Liu, Chia Y.

AU - Marchlinski, Francis E.

AU - Spooner, Peter

AU - Berger, Ronald D.

AU - Kellman, Peter

AU - Lima, Joao A C

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N2 - 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.

AB - 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.

KW - Atrial fibrillation

KW - Cardiac magnetic resonance

KW - Intraatrial infiltrated fat

KW - Risk score

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