Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation

Heart Rhythm O2

Shintaro Kira, MD, PhD¹  Taisuke Harada, MD²  Kunio Yufu, MD, PhD²  Ichitaro Abe, MD, PhD²  Hidekazu Kondo, MD, PhD²  Takashi Shuto, MD, PhD²  Takahiro Oniki, MD, PhD²  Yumi Ishii, MD²  Masayuki Takano, MD²  Yasushi Teshima, MD, PhD²  Naohiko Takahashi, MD, PhD³  Tomoyuki Wada, MD, PhD³  Mikiko Nakagawa, MD, PhD³  Shinji Miyamoto, MD, PhD⁴  Tatsuo Shimada, PhD⁵  Yoshiki Asayama, MD, PhD⁶ 

[1] Address reprint requests and correspondence: Dr Ichitaro Abe / Dr Naohiko Takahashi, Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita 879-5593, Japan.;Department of Cardiology and Clinical Examination;Department of Cardiovascular Surgery;Department of Radiology, Oita University Faculty of Medicine, Oita, Japan;Medical Education Center, and;Oita Medical Technology School, College of Judo Therapy and Acupuncture-Moxibustion, Oita, Japan;

关键词: Atrial fibrillation;    Computed tomography;    Epicardial adipose tissue;    Fat attenuation;    Fibrosis;    Inflammation;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Fibrotic remodeling of epicardial adipose tissue (EAT) is crucial for proinflammatory atrial myocardial fibrosis, which leads to atrial fibrillation (AF). Objectives: We tested the hypothesis that the ratio of central to marginal adipocyte diameter in EAT represents its fibrotic remodeling. Based on a similar concept, we also tested whether the percent (%) change in EAT fat attenuation determined using computed tomographic (CT) images can detect this remodeling. Methods: Left atrial appendages were obtained from 76 consecutive AF patients during cardiovascular surgery. EAT in the central area (central EAT: C-EAT) and that adjacent to the atrial myocardium (Marginal EAT: M-EAT) were evaluated histologically. CT images for all of the 76 patients were also analyzed. Results: The adipocyte diameter was smaller, fibrotic remodeling of EAT (EAT fibrosis) was more severe, and infiltration of macrophages and myofibroblasts was more extensive in M-EAT than in C-EAT. EAT fibrosis was positively correlated with adipocyte diameter in C-EAT and negatively correlated in M-EAT, resulting in a positive correlation between EAT fibrosis and the ratio of central to marginal adipocyte diameter (C/M diameter ratio; r = 0.73, P < .01). The C/M diameter ratio was greater in patients with persistent AF than in those with paroxysmal AF. CT images demonstrated that the %change in EAT fat attenuation was positively correlated with EAT fibrosis. Conclusion: Our results suggest that the central-to-marginal adipocyte diameter ratio is tightly associated with fibrotic remodeling of EAT. In addition, the %change in EAT fat attenuation determined using CT imaging can detect remodeling noninvasively.

【 授权许可】

Unknown