The Relationship Of Epicardial Adipose Tissue To The Thromboembolism Event In Atrial Fibrillation Patients

Objective:This study investigated the EAT by computed tomography (CT) and to explore the correlate between EAT volume and the history of thromboembolism.Methods:155 patients with AF were chose. One hundred and fifty-five patients were record sex, age, and comorbidties. Total EAT volume(EAT),atrial EAT volume (LA-EAT) were measured by CT. All patients were divided into 2 groups (embolic event group and control group) based on the history of thromboembolism, then the parameters between the two groups were compared, and the relationship between EAT-total, EAT-LA and history of thromboembolism were evaluated.95patients with AF who were not taking anticoagulants were enrolled in next study. Measured plasma indexes of the prothrombotic state, including the level of D-dimer, fibrinogen, mean platelet volume and hematocrit. These indices in AF patients were compared with those in sex-, age- and BMI-matched health control, The relationship between EAT volume and the plasma indexes of the prothrombotic state was explored.Results:(1) The increased volume of the EAT correlated with advancing age, body mass index, LA diameter, prevalence of hypertension, coronary artery disease, diabetes or vascular disease. CHA2DS2-VASc score was positively associated with volume of the EAT.(2) Of the 155 patients,22 (14%) had a history of thromboembolism.Total and atrial EAT volume were significantly bigger in patients of embolic event group than those in control group (123.49±31.25 cm3 vs.100.55±35.36 cm3, P=0.005; 34.22±6.84 cm3 vs.27.10 ± 9.55 cm3, P< 0.001). After controlling for age, Vascular disease,hypertension, diabetes and the LA diameter in a multivariable linear regression model, EAT and LA-EAT were independently associated with embolic event in patients with AF.(3) Total and atrial EAT volume were significantly greater in patients of AF group than those in control group. Multivariable analyses show that EAT volume was independently associated with the level of D-dimer and fibrinogen after adjustment for possible confounding factors.Conclusion:(1)These results suggest that EAT may contribute to increasing risk of thromboembolism. EAT in AF patients may be applied to be an indicator for thromboembolic risk.(2) EAT may modulate the pathophysiology of the prothrombotic state of AF and contribute to an increased risk of stroke and thromboembolism.