Epicardial Fat Thickness Correlates with P-wave Duration, Left Atrial Size and Decreased Left Ventricular Systolic Function in Morbid Obesity

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 27; no. 8; pp. 731 - 738
• Main Authors: Cardoso, Acácio Fernandes, MD, Furtado, Meive Santos, MD, Grindler, José, MD, Ferreira, Leandro Augusto, MD, Andrade, José Lázaro, MD, PhD, Santo, Marco Aurélio, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.08.2017
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - physiopathology; Adiposity; Adult; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - physiopathology; Atrial Function, Left; Atrial Remodeling; Cardiac function; Cardiovascular; Cross-Sectional Studies; Echocardiography; Electrocardiography; Epicardial fat thickness; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Humans; Left atrial diameter; Linear Models; Male; Middle Aged; Multivariate Analysis; Obesity; Obesity, Metabolically Benign - complications; Obesity, Metabolically Benign - diagnosis; Obesity, Metabolically Benign - physiopathology; Obesity, Morbid - complications; Obesity, Morbid - diagnosis; Obesity, Morbid - physiopathology; P-wave duration; Pericardium - diagnostic imaging; Pericardium - physiopathology; Predictive Value of Tests; Prospective Studies; Risk Factors; Stroke Volume; Systole; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left; Obesity; Left atrial diameter; P-wave duration; Cardiac function; Epicardial fat thickness
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2017.05.009

Abstract Background Epicardial fat (EF) is increased in obese and has important interactions with atrial and ventricular myocardium. Most of the evidence in this scenario can be confused by the presence of comorbidities such as hypertension, diabetes and dyslipidemia, which are very common in this population. The influence of EF on atrial remodeling and cardiac function demands further investigation on morbidly obese without these comorbidities. Methods We prospectively recruited 20 metabolically healthy morbidly obese and 20 normo-weights controls. The maximum P-wave duration (PWD) was analyzed by 12-lead electrocardiogram. Left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and EF thickness (EFT) were evaluated by two-dimensional echocardiography. Results The mean of maximum PWD and LAD were significantly larger in the obese group as compared to the control group: 109.55 ± 11.52ms x 89.38±11.19ms and 36.12 ± 3.46mm x 31.45 ± 2.64mm, (p < 0.0001). The mean LVEF was lower in the obese group: 63.15 ± 4.25% x 66.17 ± 3.37% (p < 0.017). The mean EFT was higher in the obese group: 7.72 ± 1.60mm x 3.10 ± 0.85mm (p < 0.0001). A positive correlation was found between EFT and PWD (r = 0.70; p = 0.001) and LAD (r = 0.667; p = 0.001). An inverse correlation was found between EFT and LVEF (r = - 0.523; p = 0.001). In a multiple multivariate regression analysis the EFT remains correlated with LAD and LVEF. Conclusions In a select group of morbidly obese, the excess of EF had a significant impact on atrial remodeling and cardiac function.