Elevated pericoronary adipose tissue attenuation assessed by fat attenuation index in atrial fibrillation without cardiovascular comorbidities: a retrospective observational study
- 1Department of Medical Imaging Center, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University
- 2Department of Radiology, The First Dongguan Affiliated Hospital, Guangdong Medical University
Abstract
Background: Atrial fibrillation (AF) without cardiovascular comorbidities is a distinct entity with poorly understood pathophysiology. Inflammation contributes to AF, but pericoronary adipose tissue has not been characterized in this population. We examined the association between pericoronary adipose tissue attenuation, assessed by the fat attenuation index (FAI), an imaging surrogate of inflammation-related adipose tissue remodeling rather than a direct measure of inflammation, and AF without cardiovascular comorbidities.
Methods: This retrospective, exploratory study included 125 patients undergoing coronary CT angiography (CCTA) for chest pain at two tertiary hospitals: 30 with AF without cardiovascular comorbidities (REGARDS criteria; CAD-RADS 0 coronary arteries) and 95 non-AF controls. Pericoronary FAI and fat volume were measured for the three coronary arteries (LAD, LCX, RCA). Systemic inflammatory ratios (NLR, LMR, PLR) were compared, and logistic regression identified independent predictors.
Results: FAI was significantly higher in all three coronary arteries, most markedly the RCA (-79.90 ± 7.04 vs. -89.73 ± 10.43 HU, p < 0.001; LAD and LCX both p ≤ 0.008). Although the LMR was lower in the AF group, no FAI measurement correlated with the systemic inflammatory ratios. In multivariable analysis adjusted for age and sex, RCA-FAI (OR 1.11, p < 0.001) and RCA volume (OR 2.38 per SD, p = 0.003) were independent predictors of AF without cardiovascular comorbidities.
Conclusions: AF without cardiovascular comorbidities is associated with elevated pericoronary FAI that was not explained by routine circulating leukocyte ratios. Given the sample size and the absence of tissue or cytokine confirmation, these findings are hypothesis-generating and require validation in larger prospective cohorts.
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BibTeX
@article{he2026elevated,
title = {{Elevated pericoronary adipose tissue attenuation assessed by fat attenuation index in atrial fibrillation without cardiovascular comorbidities: a retrospective observational study}},
author = {Weiheng He and Junjie Huang and Yishen Lian and Huang Li and Mingjie Chen and Jingnan Kang and Zechenrui Li and Bohong Liu and Tianxin Xu and Jiayi He and Haixin Zhang and Ziqin Wang and Congshuo Tian and Junhong Li and Jiaxin He and Xiaoshuo Huang and Yanyu Zhang and Yu Zeng and Xuewen Hou},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = nov,
doi = {10.3389/fcvm.2026.1932249},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1932249/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Elevated pericoronary adipose tissue attenuation assessed by fat attenuation index in atrial fibrillation without cardiovascular comorbidities: a retrospective observational study
AU - Weiheng He
AU - Junjie Huang
AU - Yishen Lian
AU - Huang Li
AU - Mingjie Chen
AU - Jingnan Kang
AU - Zechenrui Li
AU - Bohong Liu
AU - Tianxin Xu
AU - Jiayi He
AU - Haixin Zhang
AU - Ziqin Wang
AU - Congshuo Tian
AU - Junhong Li
AU - Jiaxin He
AU - Xiaoshuo Huang
AU - Yanyu Zhang
AU - Yu Zeng
AU - Xuewen Hou
PY - 2026
DA - 2026/11/09
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1932249
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1932249/full
AB - Background: Atrial fibrillation (AF) without cardiovascular comorbidities is a distinct entity with poorly understood pathophysiology. Inflammation contributes to AF, but pericoronary adipose tissue has not been characterized in this population. We examined the association between pericoronary adipose tissue attenuation, assessed by the fat attenuation index (FAI), an imaging surrogate of inflammation-related adipose tissue remodeling rather than a direct measure of inflammation, and AF without cardiovascular comorbidities. Methods: This retrospective, exploratory study included 125 patients undergoing coronary CT angiography (CCTA) for chest pain at two tertiary hospitals: 30 with AF without cardiovascular comorbidities (REGARDS criteria; CAD-RADS 0 coronary arteries) and 95 non-AF controls. Pericoronary FAI and fat volume were measured for the three coronary arteries (LAD, LCX, RCA). Systemic inflammatory ratios (NLR, LMR, PLR) were compared, and logistic regression identified independent predictors. Results: FAI was significantly higher in all three coronary arteries, most markedly the RCA (-79.90 ± 7.04 vs. -89.73 ± 10.43 HU, p < 0.001; LAD and LCX both p ≤ 0.008). Although the LMR was lower in the AF group, no FAI measurement correlated with the systemic inflammatory ratios. In multivariable analysis adjusted for age and sex, RCA-FAI (OR 1.11, p < 0.001) and RCA volume (OR 2.38 per SD, p = 0.003) were independent predictors of AF without cardiovascular comorbidities. Conclusions: AF without cardiovascular comorbidities is associated with elevated pericoronary FAI that was not explained by routine circulating leukocyte ratios. Given the sample size and the absence of tissue or cytokine confirmation, these findings are hypothesis-generating and require validation in larger prospective cohorts.
SN - 2297-055X
ER -