Obesity represents an important risk factor for atrial fibrillation (AF). We tested the hypothesis that pericardial fat, a unique fat deposit in close anatomic proximity to cardiac structures and autonomic fibers, is associated with prevalent AF.
Methods and Results
Participants from the Framingham Heart Study underwent multi-detector computed tomography from 2002–2005. We estimated the association between quantitative pericardial, intra-thoracic and visceral adipose tissue volumes (per standard deviation [SD] of volume) with prevalent AF adjusting for established AF risk factors (age, sex, systolic blood pressure, blood pressure treatment, PR interval and clinically significant valvular disease). Of the 3217 eligible participants (mean age 50.6±10.1 years, 48% women), 54 had a confirmed diagnosis of AF. Pericardial fat, but not intra-thoracic or visceral abdominal fat, was associated with prevalent AF in multivariable-adjusted models (Odds Ratio [OR] per SD of pericardial fat volume 1.28, 95% confidence intervals [CI] 1.03–1.58). Further adjustments for body mass index, heart failure, myocardial infarction and intra-thoracic fat volume did not materially change the association between pericardial fat and AF.
Pericardial fat was associated with prevalent AF even after adjustment for AF risk factors, including body mass index. If this association is replicated, further investigations into the mechanisms linking pericardial fat to AF are merited.
Keywords: Atrial fibrillation, pericardial, adipose tissue, obesity, epidemiology, risk factor