Relationship between epicardial adipose tissue volume and atrial fibrillation in patients with rheumatoid arthritis

Hao Yao ^* Jian Chen Xueling Li Xin Zhang

• Zhejiang Provincial People's Hospital, Hangzhou, China

Introduction: Epicardial adipose tissue (EAT) is involved in cardiac inflammatory responses and has been associated with both atrial fibrillation (AF) and rheumatoid arthritis (RA). However, the condition of EAT in RA patients with AF is still unclear. Additionally, the risks of stroke and bleeding in RA patients with AF are unknown.A retrospective analysis was conducted on patients with RA aged ≥18 years from August 2021 to May 2023, and compared with age and gender matched non-RA patients. The volume of EAT was measured using chest computed tomography (CT). Using EAT/BMI ratio to correct the possible impact of BMI differences. The stroke and bleeding risks of the patients were assessed using the CHA2DS2-VASc or HAS-BLED scores.Results: A total of 145 RA patients and 282 non-RA patients were included. The volume of EAT or EAT/BMI ratio was similar between RA without AF and non-RA without AF patients. Compared to patients without AF, those with AF had a larger EAT volume or EAT/BMI, regardless of whether they had RA or not. EAT/BMI was significantly associated with LA diameter among RA patients (RR=2.23, P<0.001) but not among non-RA patients (P<0.954). The RA groups had larger LA-EAT volume (31.53±11.02 mm 3 vs 22.56±9.58 mm 3 , p<0.001) and LA-EAT/Total EAT ratio (23.02%± 3.62% vs 18.74±3.38 mm 3 , p<0.001) than that in non-RA groups. Additionally, the proportion of patients with high stroke risk scores was higher in RA with AF patients compared to non-RA with AF (90.90% vs 72.00% in men; 84.78% vs 71.11% in women), while the proportion of patients with high bleeding risk scores was lower (22.06% vs 27.85%).LA diameter correlates with the EAT/BMI ratio in RA patients, who exhibit larger LAT-EAT volume and LAT-EAT/Total EAT ratios compared to non-RA individuals.