Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation
Background: Fibrotic remodeling of epicardial adipose tissue (EAT) is crucial for proinflammatory atrial myocardial fibrosis, which leads to atrial fibrillation (AF). Objectives: We tested the hypothesis that the ratio of central to marginal adipocyte diameter in EAT represents its fibrotic remodeli...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-08-01
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| Series: | Heart Rhythm O2 |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501821000891 |
| _version_ | 1819148768638926848 |
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| author | Yumi Ishii, MD Ichitaro Abe, MD, PhD Shintaro Kira, MD, PhD Taisuke Harada, MD Masayuki Takano, MD Takahiro Oniki, MD, PhD Hidekazu Kondo, MD, PhD Yasushi Teshima, MD, PhD Kunio Yufu, MD, PhD Takashi Shuto, MD, PhD Tomoyuki Wada, MD, PhD Mikiko Nakagawa, MD, PhD Tatsuo Shimada, PhD Yoshiki Asayama, MD, PhD Shinji Miyamoto, MD, PhD Naohiko Takahashi, MD, PhD |
| author_facet | Yumi Ishii, MD Ichitaro Abe, MD, PhD Shintaro Kira, MD, PhD Taisuke Harada, MD Masayuki Takano, MD Takahiro Oniki, MD, PhD Hidekazu Kondo, MD, PhD Yasushi Teshima, MD, PhD Kunio Yufu, MD, PhD Takashi Shuto, MD, PhD Tomoyuki Wada, MD, PhD Mikiko Nakagawa, MD, PhD Tatsuo Shimada, PhD Yoshiki Asayama, MD, PhD Shinji Miyamoto, MD, PhD Naohiko Takahashi, MD, PhD |
| author_sort | Yumi Ishii, MD |
| collection | DOAJ |
| description | Background: Fibrotic remodeling of epicardial adipose tissue (EAT) is crucial for proinflammatory atrial myocardial fibrosis, which leads to atrial fibrillation (AF). Objectives: We tested the hypothesis that the ratio of central to marginal adipocyte diameter in EAT represents its fibrotic remodeling. Based on a similar concept, we also tested whether the percent (%) change in EAT fat attenuation determined using computed tomographic (CT) images can detect this remodeling. Methods: Left atrial appendages were obtained from 76 consecutive AF patients during cardiovascular surgery. EAT in the central area (central EAT: C-EAT) and that adjacent to the atrial myocardium (Marginal EAT: M-EAT) were evaluated histologically. CT images for all of the 76 patients were also analyzed. Results: The adipocyte diameter was smaller, fibrotic remodeling of EAT (EAT fibrosis) was more severe, and infiltration of macrophages and myofibroblasts was more extensive in M-EAT than in C-EAT. EAT fibrosis was positively correlated with adipocyte diameter in C-EAT and negatively correlated in M-EAT, resulting in a positive correlation between EAT fibrosis and the ratio of central to marginal adipocyte diameter (C/M diameter ratio; r = 0.73, P < .01). The C/M diameter ratio was greater in patients with persistent AF than in those with paroxysmal AF. CT images demonstrated that the %change in EAT fat attenuation was positively correlated with EAT fibrosis. Conclusion: Our results suggest that the central-to-marginal adipocyte diameter ratio is tightly associated with fibrotic remodeling of EAT. In addition, the %change in EAT fat attenuation determined using CT imaging can detect remodeling noninvasively. |
| first_indexed | 2024-12-22T13:50:58Z |
| format | Article |
| id | doaj.art-b39ccb638aa94eaa8ab901dbfe7a98d7 |
| institution | Directory Open Access Journal |
| issn | 2666-5018 |
| language | English |
| last_indexed | 2024-12-22T13:50:58Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heart Rhythm O2 |
| spelling | doaj.art-b39ccb638aa94eaa8ab901dbfe7a98d72022-12-21T18:23:40ZengElsevierHeart Rhythm O22666-50182021-08-0124311323Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observationYumi Ishii, MD0Ichitaro Abe, MD, PhD1Shintaro Kira, MD, PhD2Taisuke Harada, MD3Masayuki Takano, MD4Takahiro Oniki, MD, PhD5Hidekazu Kondo, MD, PhD6Yasushi Teshima, MD, PhD7Kunio Yufu, MD, PhD8Takashi Shuto, MD, PhD9Tomoyuki Wada, MD, PhD10Mikiko Nakagawa, MD, PhD11Tatsuo Shimada, PhD12Yoshiki Asayama, MD, PhD13Shinji Miyamoto, MD, PhD14Naohiko Takahashi, MD, PhD15Department of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical Examination; Address reprint requests and correspondence: Dr Ichitaro Abe / Dr Naohiko Takahashi, Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Oita 879-5593, Japan.Department of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical ExaminationDepartment of Cardiology and Clinical ExaminationDepartment of Cardiovascular SurgeryDepartment of Cardiovascular SurgeryMedical Education Center, andOita Medical Technology School, College of Judo Therapy and Acupuncture-Moxibustion, Oita, JapanDepartment of Radiology, Oita University Faculty of Medicine, Oita, JapanDepartment of Cardiovascular SurgeryDepartment of Cardiology and Clinical ExaminationBackground: Fibrotic remodeling of epicardial adipose tissue (EAT) is crucial for proinflammatory atrial myocardial fibrosis, which leads to atrial fibrillation (AF). Objectives: We tested the hypothesis that the ratio of central to marginal adipocyte diameter in EAT represents its fibrotic remodeling. Based on a similar concept, we also tested whether the percent (%) change in EAT fat attenuation determined using computed tomographic (CT) images can detect this remodeling. Methods: Left atrial appendages were obtained from 76 consecutive AF patients during cardiovascular surgery. EAT in the central area (central EAT: C-EAT) and that adjacent to the atrial myocardium (Marginal EAT: M-EAT) were evaluated histologically. CT images for all of the 76 patients were also analyzed. Results: The adipocyte diameter was smaller, fibrotic remodeling of EAT (EAT fibrosis) was more severe, and infiltration of macrophages and myofibroblasts was more extensive in M-EAT than in C-EAT. EAT fibrosis was positively correlated with adipocyte diameter in C-EAT and negatively correlated in M-EAT, resulting in a positive correlation between EAT fibrosis and the ratio of central to marginal adipocyte diameter (C/M diameter ratio; r = 0.73, P < .01). The C/M diameter ratio was greater in patients with persistent AF than in those with paroxysmal AF. CT images demonstrated that the %change in EAT fat attenuation was positively correlated with EAT fibrosis. Conclusion: Our results suggest that the central-to-marginal adipocyte diameter ratio is tightly associated with fibrotic remodeling of EAT. In addition, the %change in EAT fat attenuation determined using CT imaging can detect remodeling noninvasively.http://www.sciencedirect.com/science/article/pii/S2666501821000891Atrial fibrillationComputed tomographyEpicardial adipose tissueFat attenuationFibrosisInflammation |
| spellingShingle | Yumi Ishii, MD Ichitaro Abe, MD, PhD Shintaro Kira, MD, PhD Taisuke Harada, MD Masayuki Takano, MD Takahiro Oniki, MD, PhD Hidekazu Kondo, MD, PhD Yasushi Teshima, MD, PhD Kunio Yufu, MD, PhD Takashi Shuto, MD, PhD Tomoyuki Wada, MD, PhD Mikiko Nakagawa, MD, PhD Tatsuo Shimada, PhD Yoshiki Asayama, MD, PhD Shinji Miyamoto, MD, PhD Naohiko Takahashi, MD, PhD Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation Heart Rhythm O2 Atrial fibrillation Computed tomography Epicardial adipose tissue Fat attenuation Fibrosis Inflammation |
| title | Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation |
| title_full | Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation |
| title_fullStr | Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation |
| title_full_unstemmed | Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation |
| title_short | Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation |
| title_sort | detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation imaging approach based on histological observation |
| topic | Atrial fibrillation Computed tomography Epicardial adipose tissue Fat attenuation Fibrosis Inflammation |
| url | http://www.sciencedirect.com/science/article/pii/S2666501821000891 |
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