論文

国際誌
2021年8月

Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation.

Heart rhythm O2
  • Yumi Ishii
  • ,
  • Ichitaro Abe
  • ,
  • Shintaro Kira
  • ,
  • Taisuke Harada
  • ,
  • Masayuki Takano
  • ,
  • Takahiro Oniki
  • ,
  • Hidekazu Kondo
  • ,
  • Yasushi Teshima
  • ,
  • Kunio Yufu
  • ,
  • Takashi Shuto
  • ,
  • Tomoyuki Wada
  • ,
  • Mikiko Nakagawa
  • ,
  • Tatsuo Shimada
  • ,
  • Yoshiki Asayama
  • ,
  • Shinji Miyamoto
  • ,
  • Naohiko Takahashi

2
4
開始ページ
311
終了ページ
323
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.hroo.2021.05.006

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.

リンク情報
DOI
https://doi.org/10.1016/j.hroo.2021.05.006
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34430935
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369308
ID情報
  • DOI : 10.1016/j.hroo.2021.05.006
  • PubMed ID : 34430935
  • PubMed Central 記事ID : PMC8369308

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