TABLE 1.
Associations between EAT and AF occurrence, severity and outcome.
| References | Study population | EAT measure | Main finding |
| Maeda et al. (89) | 218 AF patients undergoing AF ablation; Mean age ± SD: 64 ± 10.1; Male 74.8%; |
EAT Volume at multidetector CT | EAT volume is a predictor of post-ablation recurrence of AF HR: 1.02 (95% CI: 1.00–1.03) P = 0.012 |
| Tsao et al. (90) | 115 subjects; Mean age ± SD: 63.5 ± 8.7; Male 75%; Sinus rhythm: 20 (17%); AF patients with stroke: 27 (24%); AF patients without stroke: 68 (59%) |
EAT Volume at 64-slice multidetector CT | EAT volume is independently associated with the risk of AF-related stroke; OR: 1.12 (95% CI: 1.06–1.19) P < 0.001 EAT volume correlates to contractile dysfunction of the left atrium (r = –0.369, P < 0.001) and circulatory stasis of the atrial appendix (r = –0.466, P < 0.001). |
| Chu et al. (91) | 190 persistent AF patients Mean age ± SD: 70 ± 10; Male 67%; |
EAT Thickness at echocardiography | EAT thickness is associated with worse cardiovascular outcome: cardiovascular mortality, hospitalization for heart failure, myocardial infarction, and stroke; OR 1.224, 95% CI: 1.096–1.368, P < 0.001 |
| Muhib et al. (82) | 62 patients with hypertrophic cardiomyopathy: Mean age ± SD: 56.8 ± 14; Male 58%; Sinus rhythm: 52 (84%); AF patients: 10 (16%) |
EAT Area at CMR | Increased EAT area is significantly related to the presence of AF, independently of sex, age and BMI OR: 1.28 (95% CI: 1.01–1.63) P = 0.04 |
| Tsao et al. (80) | 102 subjects; Mean age ± SD: 54.4 ± 8.7; Male 71,5%; Sinus rhythm: 34 (33%); AF patients: 68 (67%) |
EAT Volume at 64-slice multidetector CT | EAT amount is associated with AF occurrence: EAT volume is significantly increased in patients with AF compared to controls (P < 0.01); Increased EAT is independently related to AF recurrence after ablation (P = 0.038). |
| Wong et al. (88) | 130 subjects; Mean age ± SD: 56 ± 7,5; Male 71,8%; Sinus rhythm: 20 (15%); AF patients undergoing first-time AF ablation: 110 (85%) |
EAT Volume at CMR | EAT volume is associated with the presence [OR: 13.28 (95% CI: 2.23–79.98) P = 0.005] and the severity of AF [OR: 3.28 (95% CI: 1.25–8.59) P = 0.015], left atrial volumes (r = 0.49 P < 0.01) and poorer outcomes after AF ablation (p = 0.035 by log-rank test). |
| Shin et al. (83) | 160 subjects; Mean age ± SD 51.6 ± 12; Male 72,5%; Sinus rhythm: 80 (50%); Paroxysmal AF: 40 (25%); Persistent AF: 40 (25%) |
EAT Volume and Thickness at multislice CT | EAT Volume and periatrial EAT Thickness are significantly larger in AF patients compared to controls and are closely related to the chronicity of AF (P < 0.01) |
| Thanassoulis et al. (79) | 3217 individuals from the Framingham Heart Study Mean age ± SD 50.6 ± 10.1; Male 52%; AF: 54 (1,7%) |
EAT Volume at multidetector CT | EAT volume is associated with the prevalence of AF, independently by traditional AF risk factors, including BMI OR: 1.28 (95% CI: 1.01–1.63) P = 0.04 |
| Al Chekakie et al. (81) | 273 subjects; Mean age ± SD: 57 ± 12.3; Male 67%; Sinus rhythm: 76 (27,8%); Paroxysmal AF: 126 (46,1%); Persistent AF: 71 (26%) |
EAT Volume at 64-slice multidetector CT | EAT volume is associated with AF, independently of traditional risk factors including BMI and left atrial enlargement OR: 1.13 (95% CI: 1.03–1.24) P = 0.01 EAT volume is larger in patients with persistent AF compared to patients with paroxysmal AF or sinus rhythm (P < 0.01) |
| Batal et al. (8) | 169 subjects; Mean age ± SD: 54.6 ± 13.2; Male 65,1%; Sinus rhythm: 73 (43,2%); Paroxysmal AF: 60 (35,5%); Persistent AF: 36 (21,3%) |
EAT Thickness at 64-slice multidetector CT | Increased left atrium EAT thickness is associated with AF burden independently of age, BMI or left atrium area OR: 5.30 (95% CI: 1.39–20.24) P = 0.015 |
EAT, epicardial adipose tissue; CT, computed tomography; AF, atrial fibrillation; BMI, body max index; CMR, cardiac magnetic resonance; SD, standard deviation; 95% CI, 95% confidence interval; OR, odds ratio; HR, hazard ratio; r, correlation (Pearson or Spearman).