Emerging
evidence suggests that epicardial and pericardial fat are related to the
presence, severity and outcome of AF. These associations, independent of
generalized obesity, suggest that they may become increasingly useful as
markers for risk stratification or monitoring in the clinical setting.
Mechanistically, studies have suggested the effects of epicardial and
pericardial fat may be mediated by local adipokines, inflammation, fatty
infiltration, modulation of AF drivers and left atrial dilatation. Given the
interrelated epidemics of AF and obesity, the role that the adipose tissue
surrounding the heart has in the pathogenesis of AF remains an active area of
investigation. This may ultimately lead to new insights in combatting these
dual epidemics.
Credits: Christopher X. Wong, MBBS; Rajiv Mahajan, MD; Rajeev Pathak, MBBS; Darragh J. Twomey, MBBS; Prashanthan Sanders, MBBS, PhD, FHRS