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Type: Journal article
Title: Associations of epicardial, abdominal, and overall adiposity with atrial fibrillation
Author: Wong, C.
Sun, M.
Odutayo, A.
Emdin, C.
Mahajan, R.
Lau, D.
Pathak, R.
Wong, D.
Selvanayagam, J.
Sanders, P.
Clarke, R.
Citation: Circulation: Arrhythmia and Electrophysiology, 2016; 9(12):1-29
Publisher: American Heart Association
Issue Date: 2016
ISSN: 1941-3149
Statement of
Christopher X. Wong, Michelle T. Sun, Ayodele Odutayo, Connor A. Emdin, Rajiv Mahajan, Dennis H. Lau, Rajeev K. Pathak, Dennis T. Wong, Joseph B. Selvanayagam, Prashanthan Sanders, Robert Clarke
Abstract: Background—Although adiposity is increasingly recognized as a risk factor for atrial fibrillation (AF), the importance of epicardial fat compared with other adipose tissue depots remains uncertain. We sought to characterize and compare the associations of AF with epicardial fat and measures of abdominal and overall adiposity. Methods and Results—We conducted a meta-analysis of 63 observational studies including 352 275 individuals, comparing AF risk for 1-SD increases in epicardial fat, waist circumference, waist/hip ratio, and body mass index. A 1-SD higher epicardial fat volume was associated with a 2.6-fold higher odds of AF (odds ratio, 2.61; 95% confidence interval [CI], 1.89–3.60), 2.1-fold higher odds of paroxysmal AF (odds ratio, 2.14; 95% CI, 1.45–3.16) and, 5.4-fold higher odds of persistent AF (odds ratio, 5.43; 95% CI, 3.24–9.12) compared with sinus rhythm. Likewise, a 1-SD higher epicardial fat volume was associated with 2.2-fold higher odds of persistent compared with paroxysmal AF (odds ratio, 2.19; 95% CI, 1.66–2.88). Similar associations existed for postablation, postoperative, and postcardioversion AF. In contrast, associations of abdominal and overall adiposity with AF were less extreme, with relative risks per 1-SD higher values of 1.32 (95% CI, 1.25–1.41) for waist circumference, 1.11 (95% CI, 1.08–1.14) for waist/hip ratio, and 1.22 (95% CI, 1.17–1.27) for body mass index. Conclusions—Strong and graded associations were observed between increasing epicardial fat and AF. Moreover, the strength of associations of AF with epicardial fat is greater than for measures of abdominal or overall adiposity. Further studies are needed to assess the mechanisms and clinical relevance of epicardial fat.
Keywords: abdominal fat; adipose tissue; atrial fibrillation; meta-analysis; obesity
Rights: Copyright © 2016 American Heart Association, Inc. All rights reserved.
RMID: 0030059554
DOI: 10.1161/CIRCEP.116.004378
Appears in Collections:Medicine publications

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