TY - JOUR
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 G.
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.
PY - 2014/3/1
Y1 - 2014/3/1
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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U2 - 10.1016/j.ijcard.2014.01.012
DO - 10.1016/j.ijcard.2014.01.012
M3 - Article
C2 - 24485635
AN - SCOPUS:84894090393
SN - 0167-5273
VL - 172
SP - 196
EP - 201
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -