Epicardial Adipose Tissue Is Associated With Left Atrial Dysfunction in People Without Obstructive Coronary Artery Disease or Atrial Fibrillation

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. This study aims to evaluate the relationships between EAT volumes, LA function, and LA global longitudinal strain. One hundred and thirty people without obstructive coronary artery disease or AF were prospectively recruited into the study in Australia and underwent cardiac computed tomography and echocardiography. EAT volume was quantified from cardiac computed tomography. Echocardiographic 3-dimensional (3D) volumetric measurements and 2D speckle-tracking analysis were performed. Using the overall median body surface area–indexed total EAT volume (EATi), the study cohort was divided into 2 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 < 0.001). Total EATi volume was a predictor of impaired 2D LA global longitudinal strain (standardized β = −0.204, 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. Indexed EAT volume is independently associated with subclinical LA dysfunction and impaired global longitudinal strain in people without obstructive coronary artery disease or a history of AF. Le tissu adipeux épicardique (TAE) est un dépôt de graisse viscérale métaboliquement active. Bien que le volume du TAE soit associé à l’incidence et au fardeau de la fibrillation auriculaire (FA), on ignore son rôle dans la dysfonction sous-clinique de l’oreillette gauche (OG). La présente étude a pour objectif d’évaluer les relations entre les volumes du TAE, la fonction de l’OG et la déformation longitudinale globale de l’OG. Cent trente personnes non atteintes de coronaropathie obstructive ou de FA ont été recrutées de façon prospective au sein de l’étude en Australie et ont subi une tomodensitométrie du cœur et une échocardiographie. Le volume du TAE a été quantifié par tomodensitométrie du cœur. Les mesures volumétriques en échocardiographie tridimensionnelle (3D) et les analyses Speckle Tracking (suivi de pixel