@article{3181477,
    title = "Opposite relations of epicardial adipose tissue to left atrial size in
paroxysmal and permanent atrial fibrillation",
    author = "Psychari, Stavroula N. and Tsoukalas, Dionysios and Varvarousis, and Dimitrios and Papaspyropoulos, Anastasios and Gkika, Eleni and Kotsakis, and Athanasios and Paraskevaidis, Ioannis A. and Iliodromitis, Efstathios K.",
    journal = "Sage Open Medicine",
    year = "2018",
    volume = "6",
    publisher = "SAGE Publications Inc.",
    issn = "2050-3121",
    doi = "10.1177/2050312118799908",
    keywords = "Epicardial fat; atrial fibrillation; adiponectin",
    abstract = "Objectives: Atrial fibrillation has been associated with obesity in
epidemiological studies. Epicardial adipose tissue is an ectopic fat
depot in the proximity of atria, with endocrine and inflammatory
properties that is implicated in the pathophysiology of atrial
fibrillation. Inflammation also has a role in atrial arrhythmogenesis.
The aim of this study was to investigate the potential relations of
epicardial adipose tissue to left atrial size and to adiponectin and the
pro-inflammatory mediators, high-sensitivity C-reactive protein, and
interleukin-6 in paroxysmal and permanent atrial fibrillation.
Methods: This was a cross-sectional study of 103 atrial fibrillation
patients, divided into two subgroups of paroxysmal and permanent atrial
fibrillation, and 81 controls, in sinus rhythm. Echocardiography was
used for estimation of epicardial adipose tissue and left atrial size
and high-sensitivity C-reactive protein, interleukin-6 and adiponectin
were measured in all subjects.
Results: Atrial fibrillation patients had significantly larger
epicardial adipose tissue compared with controls (0.430.17 vs 0.34 +/-
0.17cm, p=0.002). Atrial fibrillation presence was independently related
to epicardial adipose tissue thickness (b=0.09, p=0.002). Opposite
associations of epicardial adipose tissue with left atrial volume
existed in atrial fibrillation subgroups; in the paroxysmal subgroup,
epicardial adipose tissue was directly related to left atrial volume
(R=0.3, p=0.03), but in the permanent one the relation was inverse
(R=-0.7, p<0.0001). Adiponectin, high-sensitivity C-reactive protein and
interleukin-6 were elevated in both atrial fibrillation groups. Only
interleukin-6 was related to epicardial adipose tissue size.
Conclusion: Opposite associations of epicardial adipose tissue with left
atrial size in paroxysmal and permanent Atrial fibrillation and elevated
inflammatory markers, suggest a role of epicardial adipose tissue and
inflammation in the fibrotic and remodeling process."
}