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Background <p>Epicardial adipose tissue (EAT) is a metabolically active fat depot that may influence left atrial (LA) function through paracrine effects. EAT has been linked to myocardial fibrosis and early cardiac remodeling. LA dysfunction can lead to increased risk of cardiovascular complications, including atrial fibrillation (AF) and heart failure. This study aimed to investigate the association between EAT and subclinical LA dysfunction in patients without obstructive coronary artery disease (CAD).</p> Methods <p>We prospectively enrolled 93 patients through a prospectively conducted cross-sectional study who underwent cardiac computed tomography (CT) for exclusion of obstructive CAD. EAT volume was measured and indexed to body surface area (EATi). 2D/3D-speckle-tracking echocardiography was used to assess global LA longitudinal strain (GLS). Patients were stratified into two groups according to EATi (≥ 48.4 cm<sup>3</sup>/m<sup>2</sup> vs. &lt; 48.4 cm<sup>3</sup>/m<sup>2</sup>). Multivariable linear regression was performed to identify independent predictors of LA strain.</p> Results <p>The mean age of the study population was 55.7 ± 9.9&#xa0;years, and 60.2% were male. Patients with higher EATi had significantly lower LA GLS (35.4 ± 9.8% vs. 43.6 ± 10.5%, <i>p</i> &lt; 0.001). In multivariable analysis, EATi remained independently associated with impaired LA strain (β = –0.28, 95% CI: –0.45 to –0.09, <i>p</i> = 0.004) after adjusting for age, BMI, LV mass index, and E/e′ ratio. Although the ROC analysis later identified a threshold of ≥ 57 cm<sup>3</sup>/m<sup>2</sup> with high specificity for LA dysfunction, this should be interpreted cautiously, and further validation in larger cohorts is needed.</p> Conclusions <p>Increased epicardial adipose tissue is independently associated with subclinical LA dysfunction. EAT may represent a modifiable risk marker linked to atrial remodeling, warranting further investigation.</p>

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Association of Subclinical Left Atrial Dysfunction with Epicardial Adipose Tissue

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Mahmoud F. Elshahat,
  • Hamada Alsheikh,
  • Arafa Gomaa Mohamed

摘要

Background

Epicardial adipose tissue (EAT) is a metabolically active fat depot that may influence left atrial (LA) function through paracrine effects. EAT has been linked to myocardial fibrosis and early cardiac remodeling. LA dysfunction can lead to increased risk of cardiovascular complications, including atrial fibrillation (AF) and heart failure. This study aimed to investigate the association between EAT and subclinical LA dysfunction in patients without obstructive coronary artery disease (CAD).

Methods

We prospectively enrolled 93 patients through a prospectively conducted cross-sectional study who underwent cardiac computed tomography (CT) for exclusion of obstructive CAD. EAT volume was measured and indexed to body surface area (EATi). 2D/3D-speckle-tracking echocardiography was used to assess global LA longitudinal strain (GLS). Patients were stratified into two groups according to EATi (≥ 48.4 cm3/m2 vs. < 48.4 cm3/m2). Multivariable linear regression was performed to identify independent predictors of LA strain.

Results

The mean age of the study population was 55.7 ± 9.9 years, and 60.2% were male. Patients with higher EATi had significantly lower LA GLS (35.4 ± 9.8% vs. 43.6 ± 10.5%, p < 0.001). In multivariable analysis, EATi remained independently associated with impaired LA strain (β = –0.28, 95% CI: –0.45 to –0.09, p = 0.004) after adjusting for age, BMI, LV mass index, and E/e′ ratio. Although the ROC analysis later identified a threshold of ≥ 57 cm3/m2 with high specificity for LA dysfunction, this should be interpreted cautiously, and further validation in larger cohorts is needed.

Conclusions

Increased epicardial adipose tissue is independently associated with subclinical LA dysfunction. EAT may represent a modifiable risk marker linked to atrial remodeling, warranting further investigation.