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ASSOCIATION OF EPICARDIAL ADIPOSE TISSUE WITH PREVALENT AND INCIDENT ATRIAL FIBRILLATION IN THE GENERAL POPULATION: THE HEINZ NIXDORF RECALL STUDY
E993 JACC March 12, 2013 Volume 61, Issue 10
Imaging Association of Epicardial Adipose Tissue with Prevalent and Incident Atrial Fibrillation in the General Population: The Heinz Nixdorf Recall Study Poster Contributions Poster Sessions, Expo North Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality VI Abstract Category: 20. Imaging: CT/Multimodality Presentation Number: 1230-364 Authors: Amir A. Mahabadi, Nils Lehmann, Marie H. Berg, Hagen Kälsch, Marcus Bauer, Kaffer Kara, Susanne Moebus, Karl-Heinz Jöckel, Raimund Erbel, Stefan Möhlenkamp, Department of Cardiology, West-German Heart Center, University of Duisburg-Essen, Essen, Germany, Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany Background: Epicardial adipose tissue (EAT) is associated with prevalent atrial fibrillation (AF), which was explained by the inflammatory modulation effect of EAT. However to date, information on EAT and incident AF suggesting a pathogenetic effect of EAT in development of AF is lacking. We aimed to determine the association of EAT volume with prevalent and incident AF in the general population. Methods: Participants from the Heinz Nixdorf Recall study without known cardiovascular disease were included for this analysis. At baseline, EAT volume was defined as fat inside the pericardial sac and quantified from non-contrast enhanced cardiac computed tomography. AF was determined from ECG at baseline as well as at 5-year follow-up examination. Logistic regression analysis was performed to determine the association of EAT with AF in unadjusted, AF risk factors (including age, gender, BMI, systolic blood pressure, and antihypertensive medication), and ancillary left atrial size adjusted models. Results: Overall, 3905 subjects (mean age 59 ± 7.7 years, 47.2% male) were included. Of those, 46 subjects had AF at baseline examination. Additional 50 subjects with sinus rhythm at baseline showed AF at follow up. Subjects with AF at baseline or follow-up had higher EAT volumes compared to subjects in sinus rhythms in both examinations (138.7 ± 64.7 vs. 94.6 ± 47.6 ml, p<0.0001). EAT volume was associated with prevalent AF in unadjusted logistic regression and when adjusting for AF risk factors (unadjusted odds ratio (OR, 95%CI): 4.26 (2.70-6.72), p<0.0001; adjusted OR (95%CI): 2.40 (1.32-4.38), p=0.004) per each doubling of EAT). Further adjusting for LA size diminished the association of EAT with prevalent AF (OR(95%CI): 1.84 (0.96-3.50), p=0.065). In contrast, EAT was associated with incident AF in unadjusted analysis (OR(95%CI): 2.62 (1.72-3.99), p<0.0001), however, this was no longer present when adjusting for AF risk factors (OR(95%CI): 1.14 (0.66-1.98), p=0.64). Conclusion: EAT is associated with prevalent AF, while the link with incident AF was ultimately explained by shared risk factors. Further studies with longer follow-up and more frequent ECGs are needed to confirm our results.
Imaging Association of Epicardial Adipose Tissue with Prevalent and Incident Atrial Fibrillation in the General Population: The Heinz Nixdorf Recall Study Poster Contributions Poster Sessions, Expo North Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality VI Abstract Category: 20. Imaging: CT/Multimodality Presentation Number: 1230-364 Authors: Amir A. Mahabadi, Nils Lehmann, Marie H. Berg, Hagen Kälsch, Marcus Bauer, Kaffer Kara, Susanne Moebus, Karl-Heinz Jöckel, Raimund Erbel, Stefan Möhlenkamp, Department of Cardiology, West-German Heart Center, University of Duisburg-Essen, Essen, Germany, Institute of Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen, Germany Background: Epicardial adipose tissue (EAT) is associated with prevalent atrial fibrillation (AF), which was explained by the inflammatory modulation effect of EAT. However to date, information on EAT and incident AF suggesting a pathogenetic effect of EAT in development of AF is lacking. We aimed to determine the association of EAT volume with prevalent and incident AF in the general population. Methods: Participants from the Heinz Nixdorf Recall study without known cardiovascular disease were included for this analysis. At baseline, EAT volume was defined as fat inside the pericardial sac and quantified from non-contrast enhanced cardiac computed tomography. AF was determined from ECG at baseline as well as at 5-year follow-up examination. Logistic regression analysis was performed to determine the association of EAT with AF in unadjusted, AF risk factors (including age, gender, BMI, systolic blood pressure, and antihypertensive medication), and ancillary left atrial size adjusted models. Results: Overall, 3905 subjects (mean age 59 ± 7.7 years, 47.2% male) were included. Of those, 46 subjects had AF at baseline examination. Additional 50 subjects with sinus rhythm at baseline showed AF at follow up. Subjects with AF at baseline or follow-up had higher EAT volumes compared to subjects in sinus rhythms in both examinations (138.7 ± 64.7 vs. 94.6 ± 47.6 ml, p<0.0001). EAT volume was associated with prevalent AF in unadjusted logistic regression and when adjusting for AF risk factors (unadjusted odds ratio (OR, 95%CI): 4.26 (2.70-6.72), p<0.0001; adjusted OR (95%CI): 2.40 (1.32-4.38), p=0.004) per each doubling of EAT). Further adjusting for LA size diminished the association of EAT with prevalent AF (OR(95%CI): 1.84 (0.96-3.50), p=0.065). In contrast, EAT was associated with incident AF in unadjusted analysis (OR(95%CI): 2.62 (1.72-3.99), p<0.0001), however, this was no longer present when adjusting for AF risk factors (OR(95%CI): 1.14 (0.66-1.98), p=0.64). Conclusion: EAT is associated with prevalent AF, while the link with incident AF was ultimately explained by shared risk factors. Further studies with longer follow-up and more frequent ECGs are needed to confirm our results.