Epicardial adipose tissue is associated with left atrial dysfunction in people without obstructive coronary artery disease or atrial fibrillation

Abstract Background Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot. Although EAT volume is associated with the incidence and burden of atrial fibrillation (AF), its role in subclinical left atrial (LA) dysfunction is unclear. The present study aims to evaluate the relationships between EAT volumes, LA function and LA global longitudinal strain. Methods One hundred and thirty people without obstructive coronary artery disease (CAD) or AF were prospectively recruited into the study in Australia and underwent cardiac computed tomography (CT) and echocardiography. EAT volume was quantified from cardiac CT. Echocardiographic 3-dimensional (3D) volumetric measurements and 2-dimensional (2D) speckle-tracking analysis were performed. Results Using the overall median BSA-indexed total EAT volume (EATi), the study cohort was divided into two groups of larger and smaller EATi volume. Subjects with larger EATi volume had significantly impaired LA reservoir function (3D LA ejection fraction, 46.1% ± 8.9% vs. 49.0% ± 7.0%, P =0.044) and reduced LA global longitudinal strain (37.6% ± 10.2% vs. 44.1% ± 10.7%, P P =0.034), reduced 3D LA ejection fraction (standardized β = -0.208, P =0.036) and reduced 3D active LA ejection fraction (standardized β = -0.211, P =0.017). Total EATi volume, rather than LA EATi volume, was the more important predictor of LA dysfunction. Conclusions Indexed EAT volume is independently associated with subclinical LA dysfunction and impaired global longitudinal strain in people without obstructive coronary artery disease or a