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

Echo Research & Practice volume 3, pages 5–15 (2016)Cite this article

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, p]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 (ß-coef: 0.17 & 0.15, both P < 0.05), and impaired LA reservoir and conduit function (ß-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.

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Funding

This study was in part supported by funds NSC 101-2314-B-195-020, NSC 103-2314-B-010-005-MY3, NSC 103-2314-B-195-001-MY3 and funds from Medical Research Department, Mackay Memorial Hospital.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

    Yau-Huei Lai, Cheng-Huang Su, Hung-I Yeh, Charles Jia-Yin Hou & Chung-Lieh Hung

  2. Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan

    Yau-Huei Lai, Cheng-Huang Su, Hung-I Yeh, Charles Jia-Yin Hou & Chung-Lieh Hung

  3. Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan

    Yau-Huei Lai, Cheng-Huang Su, Hung-I Yeh, Charles Jia-Yin Hou & Chung-Lieh Hung

  4. Mackay Medical College, Taipei, Taiwan

    Yau-Huei Lai, Cheng-Huang Su, Hung-I Yeh, Charles Jia-Yin Hou & Chung-Lieh Hung

  5. Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan

    Chun-Ho Yun & Fei-Shih Yang

  6. Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan

    Chun-Ho Yun & Tung-Hsin Wu

  7. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan

    Chung-Lieh Hung

  8. Cardiovascular MRI and CT Program, Baptist Cardiac Vascular Institute, Miami, FL, USA

    Ricardo C. Cury

  9. University Hospitals Case Medical Center, Cardiovascular Department, Cleveland, OH, USA

    Hiram G. Bezerra

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  1. Yau-Huei Lai
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  2. Chun-Ho Yun
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Correspondence to Chung-Lieh Hung.

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Lai, YH., Yun, CH., Su, CH. et al. Excessive interatrial adiposity is associated with left atrial remodeling, augmented contractile performance in asymptomatic population. Echo Res Pract 3, 5–15 (2016). https://doi.org/10.1530/ERP-15-0031

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Echo Research & Practice

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