The correlation of epicardial adipose tissue thickness and atrial fibrillation by echocardiography

doi:10.3877/cma.j.issn.1672-6448.2017.03.006

Abstract

Abstract:

Objective

To investigate the association between atrial fibrillation (AF) and epicardial adipose tissue (EAT) by echocardiography.

Methods

One hundred and thirty-eight patients of AF in First Affiliated Hospital of Chinese People′s Liberation Army General Hospital from March 2014 to June 2016 were divided into two groups, including paroxysmal AF group with 87 casesand persistent AF group with 51 cases, and 112 cases of sinus rhythm were chosen as control group. Epicardial adipose tissue was measured using echocardiography in all patients, and the conventional parameters were recorded. One-way analysis of variance was used to compare the thickness of EAT in patients with paroxysmal AF group, persistent AF group and sinus rhythm group, and LSD-t test was used in further comparison between two groups. Multivariable logistic regression analysis was used to analyze the risk factors of AF. The receiver-operating characteristic (ROC) cure of EAT and left atrium diameter (LAD) were drawn to predict the incidence of AF. The correlation between EAT thickness and LAD was analyzed by Pearson correlation analysis.

Results

The thickness of EAT in patients with persistent AF, paroxysmal AF and sinus rhythm group were (4.75±1.83), (4.32±1.76) and (1.38±0.68) mm, respectively. Epicardial adipose tissue was significantly larger in paroxysmal AF and persistent AF patients compared with that of sinus rhythm group, and the differences were statistically significant (t=-9.541, -11.439, both P<0.01). Logistic regression analysis indicated that EAT thickness and LAD were independent risk factors of atrial fibrillation (odds ratio: 3.17, 95% confidence interval: 1.31-7.68, P<0.01; odds ratio: 2.65, 95% confidence interval 1.69-4.15, P<0.05). The area under the curve (AUC) of EAT and LAD to predict presence of AF were 0.784 and 0.865, and the best threshold value were 4.45 mm and 40.00 mm, respectively. Pearson correlation analysis showed that the EAT thickness and LAD had significantly positive correlation (r=0.512, P<0.01).

Conclusions

The increase of EAT thickness is significantly correlated with the incidence of AF and is independent to traditional risk factors. Therefore, the increase of EAT thickness has certain clinical value to predict AF.

Key words: Epicardial adipose tissue, Atrial fibrillation, Echocardiography

Meiqing Zhang, Yue Li, Qiushuang Wang, Yanan Zhai, Liqun Wei, Dangsheng Huang. The correlation of epicardial adipose tissue thickness and atrial fibrillation by echocardiography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(03): 186-192.

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Figures/Tables 5

References 22

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组别	例数	年龄（岁，±s）	性别（例，男性/女性）	高血压[例（%）]	糖尿病[例（%）]	冠心病[例（%）]	BMI（±s）	LVEF（±s）
窦性心律组	112	68.2±10.6	67/45	49（44）	31（28）	29（25）	25.9±8.3	56.5±8.9
阵发性房颤组	87	68.3±11.1	56/31	42（59）	28（35）	25（29）	25.1±3.3	57.5±10.7
持续性房颤组	51	70.5±10.7	24/27	27（62）	18（32）	16（32）	24.9±3.6	55.2±7.3
F值	?	0.927	0.165	1.803	1.927	0.343	0.165	0.987
P值	?	0.162	0.902	0.073	0.064	0.220	0.902	0.260
组别	例数	LAD（mm，±s）	LDL-C（mmol/L，±s）	HDL-C（mmol/L，±s）	TG（mmol/L，±s）	CHO（mmol /L，±s）	EAT（mm，±s）
窦性心律组	112	31.5±3.8^a	2.73±0.84	1.25±0.27^c	1.31±0.70	4.63±1.10	1.38±0.68^d
阵发性房颤组	87	41.3±4.9	2.82±0.58	1.13±0.45	1.33±0.67	4.71±0.98	4.32±1.76
持续性房颤组	51	43.8±4.7^b	2.69±0.34	1.10±0.48	1.14±0.51	4.59±1.20	4.75±1.83
F值	?	70.520	1.756	6.087	0.336	0.649	35.958
P值	?	<0.001	0.087	0.026	0.785	0.413	<0.001

组别	例数	年龄（岁，±s）	性别（例，男性/女性）	高血压[例（%）]	糖尿病[例（%）]	冠心病[例（%）]	BMI（±s）	LVEF（±s）
窦性心律组	112	68.2±10.6	67/45	49（44）	31（28）	29（25）	25.9±8.3	56.5±8.9
阵发性房颤组	87	68.3±11.1	56/31	42（59）	28（35）	25（29）	25.1±3.3	57.5±10.7
持续性房颤组	51	70.5±10.7	24/27	27（62）	18（32）	16（32）	24.9±3.6	55.2±7.3
F值	?	0.927	0.165	1.803	1.927	0.343	0.165	0.987
P值	?	0.162	0.902	0.073	0.064	0.220	0.902	0.260
组别	例数	LAD（mm，±s）	LDL-C（mmol/L，±s）	HDL-C（mmol/L，±s）	TG（mmol/L，±s）	CHO（mmol /L，±s）	EAT（mm，±s）
窦性心律组	112	31.5±3.8^a	2.73±0.84	1.25±0.27^c	1.31±0.70	4.63±1.10	1.38±0.68^d
阵发性房颤组	87	41.3±4.9	2.82±0.58	1.13±0.45	1.33±0.67	4.71±0.98	4.32±1.76
持续性房颤组	51	43.8±4.7^b	2.69±0.34	1.10±0.48	1.14±0.51	4.59±1.20	4.75±1.83
F值	?	70.520	1.756	6.087	0.336	0.649	35.958
P值	?	<0.001	0.087	0.026	0.785	0.413	<0.001

项目	B	SE	Wald值	OR值（95%CI）	P值
年龄	0.05	0.06	0.86	1.06（0.94~1.12）	0.052
性别	0.19	0.03	0.52	0.76（0.31~1.95）	0.774
高血压	0.28	1.28	0.05	1.32（0.12~16.1）	0.828
冠心病	0.92	0.40	0.12	2.72（1.10~10.38）	0.634
糖尿病	-0.34	0.14	2.33	0.71（0.02~22.33）	0.710
BMI	-0.19	0.20	0.85	0.83（0.94~1.12）	0.355
LVEF	0.82	0.64	0.97	1.05（0.93~1.14）	0.625
LAD>40 mm	0.97	0.23	18.2	2.65（1.69~4.51）	0.010
EAT厚度	1.12	0.45	6.55	3.17（1.31~7.68）	0.000
LDL-C	0.13	0.73	0.39	2.36（0.55~20.5）	0.530
HDL-C	-0.56	0.38	0.20	-0.05（-2.47~1.62）	0.061
TG	0.85	0.32	0.26	1.13（0.26~5.73）	0.856
CHO	0.75	0.06	0.37	0.79（0.11~03.67）	0.242

项目	B	SE	Wald值	OR值（95%CI）	P值
年龄	0.05	0.06	0.86	1.06（0.94~1.12）	0.052
性别	0.19	0.03	0.52	0.76（0.31~1.95）	0.774
高血压	0.28	1.28	0.05	1.32（0.12~16.1）	0.828
冠心病	0.92	0.40	0.12	2.72（1.10~10.38）	0.634
糖尿病	-0.34	0.14	2.33	0.71（0.02~22.33）	0.710
BMI	-0.19	0.20	0.85	0.83（0.94~1.12）	0.355
LVEF	0.82	0.64	0.97	1.05（0.93~1.14）	0.625
LAD>40 mm	0.97	0.23	18.2	2.65（1.69~4.51）	0.010
EAT厚度	1.12	0.45	6.55	3.17（1.31~7.68）	0.000
LDL-C	0.13	0.73	0.39	2.36（0.55~20.5）	0.530
HDL-C	-0.56	0.38	0.20	-0.05（-2.47~1.62）	0.061
TG	0.85	0.32	0.26	1.13（0.26~5.73）	0.856
CHO	0.75	0.06	0.37	0.79（0.11~03.67）	0.242

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