Abstract 13832: Pericardial Fat Predicts Human Atrial Fibrillation
Background: Pericardial fat is a visceral adipose depot that has inflammatory properties. Atrial Fibrillation (AF) is associated with inflammation and obesity, however the relationship between AF and pericardial fat has not been investigated.
Methods: Pericardial fat volume was measured using computed tomography (CT) in 273 pts. This included 76 pts in sinus rhythm (SR) and no history of AF, 126 pts with paroxysmal AF and 71 pts with persistent AF. Pericardial fat volume was measured with a dedicated offline workstation using gated 1.5 mm slice thickness. Pixels corresponding to fat (−190 to −30 Hounsfield Units) were measured within that volume. Left atrial volume was calculated at end systole using a Tera Recon workstation (Tera Recon INC, California, USA).
Results: Patients with AF had significantly more pericardial fat compared to pts in SR (101.6 ± 44.1 ml vs 76.1 ± 36.3 ml, p<0.001). Pericardial Fat correlated with LA volume measured by CT [R= 0.36), p=0.001]. Using multiple logistic regression, pericardial fat was associated with AF [OR 1.13, 95% CI 1.03–1.24, p= 0.01] and this association was independent of LA size [OR 2.22, 95% CI 1.04–4.67, p =0.04], age [OR: 1.001, 95% CI: 0.96–1.04, p=0.96], gender [OR 1.46 95% CI: 0.68- 3.02, p =0.33], hypertension [OR: 0.83, 95% CI : 0.41–1.92, p =0.78)], left ventricular Ejection fraction [OR 1.02, 95% CI: 0.95–1.08, p = 0.23], Diabetes [OR 0.41, 95% CI 0.15–1.06, p=0.08] and body mass index [OR 1.01, 95% CI 0.95–1.08, p= 0.52]. The area under ROC curve of the model was 0.74, and the model had 96% sensitivity and 15% specificity of predicting AF with a positive predictive value of 81% and negative predictive value of 53%. A pericardial fat volume of 101 cc had the highest sensitivity (78%) and specificity (45%) for both genders.
Conclusions: Pericardial fat volume predicts AF independent of traditional risk factors. The exact role pericardial fat plays in the pathogenesis of AF requires further study.
- © 2010 by American Heart Association, Inc.