Abstract 12694: The Mechanistic Link Between Interatrial Adiposity, Morphological Left Atrial Remodeling and Functional Features in Asymptomatic Population
Introduction: Left atrial (LA) mechanics play a key role in heart failure (HF) development and atrial fibrillation. So far, the pericardial adipose tissue had been shown to exert local effects on adjacent cardiac structures. However, the precise mechanisms between regional fat and LA remodeling in asymptomatic population remains largely unexplored.
Hypothesis: We hypothesize that LA function is negatively affected by pericardial fat burden.
Methods: We studied 361 consecutive subjects (age: 51.8+/- 8.8, 31% female) free from significant valvular disorders, atrial fibrillation and clinical HF. Regional visceral adiposity including total pericardial fat (PCF) and thoracic periaortic fat (TPAF) volumes, interatrial septum (IAS) and left atrioventricular groove (AVG) fat thickness were all obtained by multidetector computed tomography (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). LA volumes, contractile performance and reservoir function as well as conduit capacity were all measured by echocardiography.
Results: All four adiposity measures (PCF, TPAF, AVG and IAS) were associated with larger LA volume indices (all p<0.05). Furthermore, IAS and AVG were related to larger LA kinetic energy and worse reservoir capacity (both p<0.05). In multivariate models, IAS fat thickness remained independently associated with increased LA conduit function (β-coef: 0.28), ejection force (β-coef: 0.15) and impaired LA reservoir function (β-coef: -0.20, all p<0.05), even after adjusting for clinical variables.
Conclusions: Accumulated visceral adiposity, especially interatrial fat depots, may be partially associated with LA structural and functional remodeling, which is characterized by impaired LA reservoir capacity, augmented contractile and conduit performance. Our data suggested that compensatory LA mechanistic adaptation with greater visceral fat burden may exist in asymptomatic population.
Author Disclosures: Y. Lai: None. C. Yun: None. J. Kuo: None. J. Hou: None. H. Yeh: None. C. Hung: None.
- © 2014 by American Heart Association, Inc.