Is Epicardial Adipose Tissue Associated with Atrial Fibrillation after
Cardiac Surgery? A Systematic Review and Meta-analysis
Abstract
Background: Although epicardial adipose tissue (EAT) has been proved be
associated with atrial fibrillation (AF) and post-ablation AF
recurrence, the relationship between EAT and AF after cardiac surgery
(AFACS) is not evident, yet. Objective: In the study, we aim to perform
a systematic review and meta-analysis to assess the association between
EAT and AFACS and whether it is independent of the measurement methods.
Methods: Systematic reach was implemented until May, 30, 2020, which
“atrial fibrillation” and “epicardial adipose tissue” were as the
main items in electronic databases. Analysis was stratified by EAT
measurement methods into three pooled meta-analyses on 1) total EAT
volume, 2) left atrium (LA)-EAT volume and 3) EAT thickness between two
groups with and without AFACS, estimating standardized mean difference
(SMD) with a random effect model. Results: Eight articles with ten
studies (546 patients) were included. Accordingly, the results of
meta-analysis showed that EAT was higher in AFACS subjects, regardless
of the methods of EAT measurement.[ total EAT volume: SMD = 0.56 ml;
95% confidence interval (CI) = 0.56-1.10ml, I2 = 0.90, P=0.04; EAT
thickness: SMD = 0.85mm; 95% CI = 0.04-1.65mm, I2 = 0.90, P=0.04;
LA-EAT volume: SMD = 0.57ml, 95% CI = 0.23-0.92ml, I2 = 0.00,
P=0.001.] And there was no evidence of publication bias. Conclusion:
EAT may be a potential marker and therapeutic target for AFACS. However,
larger scale studies are still required, and evaluation is needed to for
further estimation.