Body Fat Distribution and Left Atrial Reverse Remodeling After Catheter Ablation for Atrial Fibrillation.

Autor:	Hirose K; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Nakanishi K; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.; Department of Clinical Laboratory, The University of Tokyo, Tokyo, Japan., Daimon M; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Iwama K; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Yoshida Y; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Mukai Y; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Yamamoto Y; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Seki H; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Hirokawa M; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.; Department of Clinical Laboratory, The University of Tokyo, Tokyo, Japan., Nakao T; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Oshima T; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Matsubara T; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Shimizu Y; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Oguri G; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Kojima T; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Hasumi E; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Fujiu K; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Morita H; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan., Kurano M; Department of Clinical Laboratory, The University of Tokyo, Tokyo, Japan., Komuro I; Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	JACC. Advances [JACC Adv] 2024 May 06; Vol. 3 (6), pp. 100973. Date of Electronic Publication: 2024 May 06 (Print Publication: 2024).
DOI:	10.1016/j.jacadv.2024.100973
Abstrakt:	Background: Emerging evidence suggests a pathophysiological link between obesity and atrial fibrillation (AF). However, the contribution of body fat distribution to left atrial (LA) remodeling and its reversibility remain unclear in nonobese AF patients. Objectives: The purpose of this study was to investigate the association of body fat distribution with LA size and reverse remodeling (LARR). Methods: In total, 116 nonobese patients with AF (88 men, age 63 ± 11 years) who underwent first catheter ablation (CA) were included. Body fat distribution was assessed with bioelectrical impedance, and body fat percentage (BF%) and central fat percentage (CF%) were calculated. Patients were categorized by body size metrics (body mass index [BMI] and waist-to-hip [W/H] ratio) and fat parameters (BF% and CF%). Echocardiography was performed before and 6 months after CA. Multivariable logistic regression was used to examine the association between the 4 metrics (ie, BMI, W/H ratio, BF%, and CF%) and a lack of LARR (<15% reduction or increase in the LA volume index). Results: Body size metrics and adiposity measures were not independently associated with baseline LA size. Six months after CA, the higher W/H ratio and CF% groups exhibited persistent LA enlargement compared to their counterparts (both P  < 0.01). In the multivariable analysis, W/H ratio and CF% were associated with a lack of LARR (adjusted ORs of 3.86 and 2.81 per 0.10 and 10% increase, respectively, both P  < 0.01). The combined assessment of CF% with W/H ratio provided complementary risk stratification for persistent LA enlargement. Conclusions: Central adiposity was associated with a lack of LARR after CA, highlighting the importance of assessing body fat distribution even in nonobese patients. Competing Interests: This work was supported in part by 10.13039/100018736Kaken 22K12859. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. (© 2024 The Authors.)
Databáze:	MEDLINE
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