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The association between epicardial adipose tissue thickness around the right ventricular free wall evaluated by transthoracic echocardiography and left atrial appendage function

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Abstract

Epicardial adipose tissue (EAT) is associated with the development of atrial fibrillation (AF). EAT thickness identified on transthoracic echocardiography (TTE). The relationship between EAT volume and left atrial appendage (LAA) function is not well-known. We aimed to investigate the associations between EAT thickness and LAA emptying flow velocity and LAA orifice area. This single-center retrospective study enrolled 202 patients who underwent both TTE and transesophageal echocardiography (TEE). EAT thickness was measured on TTE in parasternal long-axis view. We measured LAA orifice areas in 41 patients with 3-dimensional TEE data. Spearman’s correlation coefficient was used to determine the relationships between EAT thickness and LAA emptying flow velocity and LAA orifice area. We created a receiver operating characteristic curve for low LAA emptying flow velocity (< 20 cm/s) and determined the best cutoff for EAT thickness according to the maximum Youden index. There was a significant negative correlation between EAT thickness and LAA emptying flow velocity (ρ = − 0.56, P < 0.001) and a significant positive correlation between EAT thickness and LAA orifice area (ρ = 0.38, P = 0.014). The best EAT thickness cutoff value for low LAA emptying flow velocity was > 5.1 mm (c-statistics, 75.7%). A thickened EATT was associated with low LAA emptying flow velocity, which increases the risk of thromboembolic phenomena in the presence of AF.

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Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Satoshi Yamaguchi

    Present address: Department of Cardiology, Nakagami Hospital, 610 Noborikawa, Okinawa, 904-2195, Japan

Authors and Affiliations

  1. Smidt Heart Institute, Cedars-Sinai Medical Center, 8700, Beverly Blvd., Los Angeles, CA, 90048, USA

    Satoshi Yamaguchi, Yuka Otaki, Balaji Tamarappoo, Jun Yoshida, Hiroki Ikenaga, John Friedman, Daniel Berman, Damini Dey & Takahiro Shiota

Authors
  1. Satoshi Yamaguchi
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  2. Yuka Otaki
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  3. Balaji Tamarappoo
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  4. Jun Yoshida
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  5. Hiroki Ikenaga
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  6. John Friedman
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  7. Daniel Berman
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  8. Damini Dey
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  9. Takahiro Shiota
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Contributions

SY originated the concept of this study; YO, BT, JF, DB, and DD measured epicardial adipose tissue volume by computed tomography; SY, JY, HI, and ST deeply discussed the result of this study; SY and JY evaluated the epicardial adipose tissue thickness in transthoracic echocardiography; and ST supervised all aspect of this study.

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Correspondence to Satoshi Yamaguchi.

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Yamaguchi, S., Otaki, Y., Tamarappoo, B. et al. The association between epicardial adipose tissue thickness around the right ventricular free wall evaluated by transthoracic echocardiography and left atrial appendage function. Int J Cardiovasc Imaging 36, 585–593 (2020). https://doi.org/10.1007/s10554-019-01748-w

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  • DOI: https://doi.org/10.1007/s10554-019-01748-w

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