Excessive interatrial adiposity is associated with left atrial remodeling, augmented contractile performance in asymptomatic population

Yau-Huei Lai; Chun-Ho Yun; Cheng-Huang Su; Fei-Shih Yang; Hung-I Yeh; Charles Jia-Yin Hou; Tung-Hsin Wu; Ricardo C Cury; Hiram G Bezerra; Chung-Lieh Hung

doi:10.1530/ERP-15-0031

Excessive interatrial adiposity is associated with left atrial remodeling, augmented contractile performance in asymptomatic population

Echo Res Pract. 2016 Mar;3(1):5-15. doi: 10.1530/ERP-15-0031. Epub 2016 Jan 5.

Authors

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan Mackay Medical College, Taipei, Taiwan.
² Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan.
³ Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan.
⁴ Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan.
⁵ Cardiovascular MRI and CT Program, Baptist Cardiac Vascular Institute, Miami, FL, USA.
⁶ University Hospitals Case Medical Center, Cardiovascular Department, Cleveland, OH, USA.
⁷ Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan Mackay Medical College, Taipei, Taiwan Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan jotaro3791@gmail.com.

Abstract

Purpose: Pericardial adipose tissue had been shown to exert local effects on adjacent cardiac structures. Data regarding the mechanistic link between such measures and left atrial (LA) structural/functional remodeling, a clinical hallmark of early stage heart failure (HF) and atrial fibrillation (AF) incidence, in asymptomatic population remain largely unexplored.

Methods: This retrospective analysis includes 356 subjects free from significant valvular disorders, atrial fibrillation, or clinical HF. Regional adipose tissue including pericardial and periaortic fat volumes, interatrial septal (IAS), and left atrioventricular groove (AVG) fat thickness were all measured by multidetector computed tomography (MDCT) (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). We measured LA volumes, booster performance, reservoir capacity as well as conduit function, and analyzed their association with adiposity measures.

Results: All four adiposity measures were positively associated with greater LA volumes (all P < 0.05), while IAS and AVG fat were also related to larger LA kinetic energy and worse reservoir capacity (both P < 0.01). In multivariate models, IAS fat thickness remained independently associated with larger LA volumes, increased LA kinetic energy and ejection force (β-coef: 0.17 & 0.15, both P < 0.05), and impaired LA reservoir and conduit function (β-coef: -0.20 & -0.12, both P < 0.05) after adjusting for clinical variables.

Conclusion: Accumulated visceral adiposity, especially interatrial fat depots, was associated with certain LA structural/functional remodeling characterized by impaired LA reservoir and conduit function though augmented kinetic energy and ejection performance. Our data suggested that interatrial fat burden may be associated with certain detrimental LA functions with compensatory LA adaptation in an asymptomatic population.

Keywords: MDCT; interatrial fat; left atrial function; pericardial fat.