Epicardial Fat and Atrial Fibrillation: the Role of Profibrogenous Mediators
- #AC/ARR 01-EP-5
- Adult Cardiac Surgery/Arrhythmias. E-POSTER (ORAL) SESSION
- E-Poster (oral)
Epicardial Fat and Atrial Fibrillation: the Role of Profibrogenous Mediators
Mari G. Arakelyan, Elena Z. Golukhova, Olga I. Gromova, Naida I. Bulaeva, Tatiana V. Mashina, Violetta S. Dzhanketova, Aygerim Z. Zholbaeva, Maria A. Shlyappo
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – A
Abstract
Background. Epicardial fat(EF) has certain paracrine functions, which could be associated with
proinflammatory and fibrotic changes in myocardium even in patients without structural heart
disease but atrial fibrillation(AF). Though pathophysiological mechanisms are not clear enough.
The most valid methods of EF assessment are cardiac magnetic resonance imaging(MRI) and
computed tomography(CT).
Purpose. To evaluate the correlates between clinical data, parameters of tissue Doppler imaging
(TDI), EF thickness by MRI and biochemical markers of fibrosis and inflammation in patients
with nonvalvular AF without concomitant coronary artery disease(CAD) with normal or slightly
enlarged left atria (LA).
Methods. In our study were enrolled 166 patients with AF. This subanalysis included 39 patients
with idiopathic AF with normal or slightly enlarged left atria (LA) (mean LA diameter
4,5±0,6cm). The mean age was 50,8±13,9 y.o., 19 (49%) were men. The absence of coronary
lesions was confirmed by angiography in all cases. Besides standard ECG and ECHO, all
patients underwent TDI and cardiac MRI with late gadolinium enhancement. The myocardial
fibrotic and proinflammatory biomarkers levels-matrix metalloproteinases (MMP-2, MMP-9),
tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were estimated.
Results. The epicardial fat thickness at anterior left ventricular (LV) wall was associated with
TIMP-1 plasma level (τ=0,71; Тcr=0,18). The significant correlation between fat thickness and
MMP-9 was defined (τ=0,65; Тcr=0,16). Among clinical factors weight was slightly associated
with fat thickness (τ=0,33; Тcr=0,26). Besides, we found correlation of MMP-9, TIMP-1 with
E/e’ by TDI (τ=0,65; Тcr=0,16 and τ=0,56; Тcr=0,21, relatively); and with maximal systolic
strain of lateral LV wall (τ=-0,37; Тcr=0,18 and τ=-0,44; Тcr=0,16, relatively) and
interventricular septum (τ=-0,36; Тcr=0,18 and τ=-0,44; Тcr=0,16, relatively).
Conclusion. The epicardial fat thickness by MRI is significantly associated with myocardial
fibrosis markers (MMP-9, TIMP-1) in patients with AF without structural heart disease. The
increasing levels of MMP-9 and TIMP-1 are associated with LV local contractility disturbances
by TDI in patients with AF, which could reflect initial presentation of atrial cardiomyopathy
even in patients with nonvalvular “nonischemic” AF with normal or slightly enlarged LA.