Epicardial obesity and left atrial mechanical dispersion in hypertensive patients with paroxysmal and persistent atrial fibrillation

Aim. To compare  the epicardial fat thickness  (EFT) in right ventricular anterior wall (RVAW) and left atrial mechanical dispersion  (LAMD) in hypertensive (HTN) patients without arrhythmias and with various types of recurrent atrial fibrillation (AF).

Material and methods. This observational  cross-sectional single-center  study included 383 patients  with HTN, of which 251 did not have AF,  61 patients  had paroxysmal,  and 71 patients  — persistent AF. Echocardiography  performed  against  the  background  of sinus rhythm assessed the EFT in RVAW. In addition, using speckle-tracking echocardiography, the LAMD was determined,  equal to the percentage of the standard  deviation of the time to peak  global longitudinal LA strain in the reservoir phase to duration of cardiac cycle.

Results. In HTN patients without AF, with paroxysmal and persistent AF, the EFT was 6,70 [5,80; 8,00], 8,20 [7,10; 9,93] and 8,70 [7,93; 10,0] mm (р<0,0001), LAMD — 0,72 [0,58; 0,93], 2,87 [2,40; 3,28] and 2,67 [2,11; 3,15]% (p<0,0001), respectively.

Conclusion. In HTN patients with paroxysmal and persistent  AF, the EFT in RVAW and LAMD is significantly greater  than in patients without arrhythmias. In patients with persistent  AF, EFT is greater than in paroxysmal AF, while LAMD practically does not differ.

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