Hany S Abed1, Adam J Nelson2, James D Richardson2, Stephen G Worthley2, Andrew Vincent2, Gary A Wittert2, Darryl P Leong3. 1. NHMRC Clinical Trials Center, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia; University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia. Electronic address: habed@gmp.usyd.edu.au. 2. University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia. 3. University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia; The Population Health Research Institute, Hamilton Health Sciences, and McMaster University, Ontario, Canada.
Abstract
BACKGROUND: Obesity and pericardial adipose tissue are independent risk factors for atrial fibrillation (AF) and adverse cardiac structural remodeling. The effect of weight reduction on pericardial adipose tissue and cardiac structure remains unknown. METHODS: We prospectively performed cardiac magnetic resonance imaging on 87 participants with AF undergoing either structured weight management (intervention) or general lifestyle advice (control). We measured pericardial adipose tissue, atrial and ventricular volumes, and myocardial mass at baseline and 12 months. RESULTS: In total, 69 participants underwent baseline and 12-month follow-up cardiac magnetic resonance imaging (intervention n = 36 and controls n = 33). From baseline to 12 months, weight loss (kg, mean [95% CI]) was greater in the intervention group from 101.5 kg (97.2-105.8 kg) to 86.5 kg (81.2-91.9 kg) as compared with controls from 102.6 kg (97.2-108.1 kg) to 98.7 kg (91.0-106.3 kg) (time-group interaction P < .001). The intervention group showed a reduction in left atrial volumes (mL) from 105.0 mL (98.9-111.1 mL) to 96.4 mL (91.6-101.1 mL), whereas the change in the control group was from 108.8 mL (99.6-117.9 mL) to 108.9 mL (99.8-118.0 mL) (time-group interaction P < .001). There was a decline in pericardial adipose tissue (cm(3)) from 140.9 cm(3) (129.3-152.4 cm(3)) to 118.8 cm(3) (108.1-129.6 cm(3)) and myocardial mass (g) from 137.6 g (128.1-147.2 g) to 123.1 g (114.5-131.7 g) in the intervention group, whereas the change in the control group was from 143.2 cm(3) (124.6-161.7 cm(3)) to 147.2 cm(3) (128.9-165.4 cm(3)) for pericardial adipose tissue and 138.3 g (124.8-151.8 g) to 140.7 g (127.4-154.1 g) for myocardial mass (both variables, time-group interaction P < .001). CONCLUSIONS: Weight reduction results in favorable structural remodeling and a reduction in pericardial adipose tissue burden.
BACKGROUND: Obesity and pericardial adipose tissue are independent risk factors for atrial fibrillation (AF) and adverse cardiac structural remodeling. The effect of weight reduction on pericardial adipose tissue and cardiac structure remains unknown. METHODS: We prospectively performed cardiac magnetic resonance imaging on 87 participants with AF undergoing either structured weight management (intervention) or general lifestyle advice (control). We measured pericardial adipose tissue, atrial and ventricular volumes, and myocardial mass at baseline and 12 months. RESULTS: In total, 69 participants underwent baseline and 12-month follow-up cardiac magnetic resonance imaging (intervention n = 36 and controls n = 33). From baseline to 12 months, weight loss (kg, mean [95% CI]) was greater in the intervention group from 101.5 kg (97.2-105.8 kg) to 86.5 kg (81.2-91.9 kg) as compared with controls from 102.6 kg (97.2-108.1 kg) to 98.7 kg (91.0-106.3 kg) (time-group interaction P < .001). The intervention group showed a reduction in left atrial volumes (mL) from 105.0 mL (98.9-111.1 mL) to 96.4 mL (91.6-101.1 mL), whereas the change in the control group was from 108.8 mL (99.6-117.9 mL) to 108.9 mL (99.8-118.0 mL) (time-group interaction P < .001). There was a decline in pericardial adipose tissue (cm(3)) from 140.9 cm(3) (129.3-152.4 cm(3)) to 118.8 cm(3) (108.1-129.6 cm(3)) and myocardial mass (g) from 137.6 g (128.1-147.2 g) to 123.1 g (114.5-131.7 g) in the intervention group, whereas the change in the control group was from 143.2 cm(3) (124.6-161.7 cm(3)) to 147.2 cm(3) (128.9-165.4 cm(3)) for pericardial adipose tissue and 138.3 g (124.8-151.8 g) to 140.7 g (127.4-154.1 g) for myocardial mass (both variables, time-group interaction P < .001). CONCLUSIONS:Weight reduction results in favorable structural remodeling and a reduction in pericardial adipose tissue burden.
Authors: Franco Giulianini; Bastiaan Geelhoed; Kathryn L Lunetta; Jeffrey R Misialek; Maartje N Niemeijer; Michiel Rienstra; Lynda M Rose; Albert V Smith; Neal A Chatterjee; Dan E Arking; Patrick T Ellinor; Jan Heeringa; Honghuang Lin; Steven A Lubitz; Elsayed Z Soliman; Niek Verweij; Alvaro Alonso; Emelia J Benjamin; Vilmundur Gudnason; Bruno H C Stricker; Pim Van Der Harst; Daniel I Chasman; Christine M Albert Journal: Circulation Date: 2016-12-14 Impact factor: 29.690