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Yuan Y, Zhu Y, Wu D, Wang J, Lin S, Zhu Y, Xu Y, Wu F. The Relationship Between Cardiac CT-based Left Atrial Structure and Epicardial Adipose Tissue and Postablation Atrial Fibrillation Recurrence Within 2 Years. J Thorac Imaging 2024:00005382-990000000-00140. [PMID: 38800955 DOI: 10.1097/rti.0000000000000789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
PURPOSE The aim of this study was to explore the association of cardiac CT-based left atrium (LA) structural and functional parameters and left atrial epicardial adipose tissue (LA-EAT) parameters with postablation atrial fibrillation (AF) recurrence within 2 years. MATERIALS AND METHODS Contrast-enhanced cardiac CT images of 286 consecutive AF patients (median age: 65 y; 97 females) who underwent initial ablation between June 2018 and June 2020 were retrospectively analyzed. Structural and functional parameters of LA, including maximum and minimum volume and ejection fraction of LA and left atrial appendage (LAA), and LA-EAT volume, were measured. The body surface area indexed maximum and minimum volume of LA (LAVImax, LAVImin) and LAA (LAAVImax, LAAVImin), and LA-EAT volume index (LA-EATVI) were calculated. Independent predictors of AF recurrence were determined using Cox regression analysis. The clinical predictors were added to the imaging predictors to build a combined model (clinical+imaging). The predictive performance of the clinical, imaging, and combined models was assessed using the area under the receiver operating characteristics curve (AUC). RESULTS A total of 108 (37.8%) patients recurred AF within 2 years after ablation at a median follow-up of 24 months (IQR=11, 32). LA and LAA size and LA-EAT volume were significantly increased in patients with AF recurrence (P<0.05). After the multivariable regression analysis, LA-EATVI, LAAVImax, female sex, AF duration, and stroke history were independent predictors for AF recurrence. The combined model exhibited superior predictive performance compare to the clinical model (AUC=0.712 vs. 0.641, P=0.023) and the imaging model (AUC=0.712 vs. 0.663, P=0.018). CONCLUSION Cardiac CT-based LA-EATVI and LAAVImax are independent predictors for postablation AF recurrence within 2 years and may provide a complementary value for AF recurrence risk assessment.
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Affiliation(s)
- Yuan Yuan
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, Jiangsu Province
| | - Yinsu Zhu
- Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia
| | - Dandan Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University
| | - Jun Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University
| | | | - Yaxin Zhu
- United Imaging Healthcare Co. Ltd, Shanghai, China
| | - Yi Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University
| | - Feiyun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University
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Chen Y, Li J, Li F, Chen Z, Chen Z, Luo J, Qiu H, Chen W, Hu J, Luo X, Tan Y, Rathinasabapathy A, Chen J, Li J. Impact of Epicardial Adipose Tissue on Right Cardiac Function and Prognosis in Pulmonary Arterial Hypertension. Chest 2024; 165:1211-1223. [PMID: 38040053 DOI: 10.1016/j.chest.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Although epicardial adipose tissue (EAT) is linked to effects on survival in left-sided heart failure, the association between EAT and right-sided heart failure caused by pulmonary arterial hypertension (PAH) remains unknown. RESEARCH QUESTION What are the potential impacts of EAT volume (EATV) on right ventricular function, biomarkers of myocardial injury, and long-term prognosis in patients with PAH? STUDY DESIGN AND METHODS A total of 135 age- and BMI-matched patients with PAH and 49 control participants were included in this study. EATV was quantified by using cardiac magnetic resonance and was related to clinical correlates, N-terminal pro-brain natriuretic peptide, and cardiac function. Levels of EATV associated with the risk of clinical worsening were evaluated on a continuous scale (restricted cubic splines) and by previously defined centile categories with Cox proportional hazards regression models and Kaplan-Meier survival estimates. RESULTS Compared with the control participants, patients with PAH had a lower EATV (ln [EATV], 3.2 ± 0.8 mL vs 3.5 ± 0.7 mL; P = .034). The association of EATV with right ventricular end-diastolic volume (Pnonlinear = .001), right ventricular end-diastolic volume index (P < .001), right ventricular cardiac output (P = .003), N-terminal pro-brain natriuretic peptide (P = .030), and the risk of clinical worsening (P = .014) was U shaped. Compared with individuals with middle-level EATV, multivariable-adjusted hazard ratio for clinical worsening was 6.0 (95% CI, 1.3-27.8) for the individuals with low-level EATV and 6.8 (95% CI, 1.5-30.2) for high-level EATV in patients with PAH. INTERPRETATION Patients with PAH had a decreased EATV compared with control participants. EATV exhibited a U-shaped association with right ventricular function and biomarkers of myocardial injury in patients with PAH. Low and high levels of EATV might reduce long-term event-free survival in patients with PAH. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry; No. ChiCTR2100049804; www.chictr.org.cn.
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Affiliation(s)
- Yusi Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Junli Li
- Department of Medical Imaging, Huizhou Municipal Central Hospital, Huizhou, China
| | - Fang Li
- Department of Radiology and Imaging, Zhuzhou Central Hospital of Central South University, Zhuzhou, China
| | - Zheng Chen
- School of Information Science and Technology, Shanghaitech University, Shanghai City, China
| | - Zhangling Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Jun Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Haihua Qiu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Wenjie Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Junjiao Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Xiaoqin Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Yingjie Tan
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | | | - Jingyuan Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China
| | - Jiang Li
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha City, China.
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Roset-Altadill A, Domenech-Ximenos B, Cañete N, Juanpere S, Rodriguez-Eyras L, Hidalgo A, Vargas D, Pineda V. Epicardial Space: Comprehensive Anatomy and Spectrum of Disease. Radiographics 2024; 44:e230160. [PMID: 38483831 DOI: 10.1148/rg.230160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The epicardial space (ES) is the anatomic region located between the myocardium and the pericardium. This space includes the visceral pericardium and the epicardial fat that contains the epicardial coronary arteries, cardiac veins, lymphatic channels, and nerves. The epicardial fat represents the main component of the ES. This fat deposit has been a focus of research in recent years owing to its properties and relationship with coronary gossypiboma plaque and atrial fibrillation. Although this region is sometimes forgotten, a broad spectrum of lesions can be found in the ES and can be divided into neoplastic and nonneoplastic categories. Epicardial neoplastic lesions include lipoma, paraganglioma, metastases, angiosarcoma, and lymphoma. Epicardial nonneoplastic lesions encompass inflammatory infiltrative disorders, such as immunoglobulin G4-related disease and Erdheim-Chester disease, along with hydatidosis, abscesses, coronary abnormalities, pseudoaneurysms, hematoma, lipomatosis, and gossypiboma. Initial imaging of epicardial lesions may be performed with echocardiography, but CT and cardiac MRI are the best imaging modalities to help characterize epicardial lesions. Due to the nonspecific onset of signs and symptoms, the clinical history of a patient can play a crucial role in the diagnosis. A history of malignancy, multisystem diseases, prior trauma, myocardial infarction, or cardiac surgery can help narrow the differential diagnosis. The diagnostic approach to epicardial lesions should be made on the basis of the specific location, characteristic imaging features, and clinical background. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Adria Roset-Altadill
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Blanca Domenech-Ximenos
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Noemi Cañete
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Sergi Juanpere
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Lucia Rodriguez-Eyras
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Alberto Hidalgo
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Daniel Vargas
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
| | - Victor Pineda
- From the Department of Radiology, Hospital Universitari de Girona Doctor Josep Trueta, Av França S/N, 17007, Girona, Spain (A.R.A., N.C., S.J., A.H., V.P.); Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain (B.D.X.); Department of Cardiology, Clinica Colon, Buenos Aires, Argentina (L.R.E.); and Division of Cardiothoracic Imaging, Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (D.V.)
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Huber AT, Fankhauser S, Wittmer S, Chollet L, Lam A, Maurhofer J, Madaffari A, Seiler J, Servatius H, Haeberlin A, Noti F, Brugger N, von Tengg-Kobligk H, Gräni C, Roten L, Tanner H, Reichlin T. Epicardial adipose tissue dispersion at CT and recurrent atrial fibrillation after pulmonary vein isolation. Eur Radiol 2024:10.1007/s00330-023-10498-2. [PMID: 38197916 DOI: 10.1007/s00330-023-10498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/03/2023] [Accepted: 11/06/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES Epicardial adipose tissue (EAT) remodeling is associated with atrial fibrillation (AF). Left atrial (LA) EAT dispersion on cardiac CT is a non-invasive imaging biomarker reflecting EAT heterogeneity. We aimed to investigate the association of LA EAT dispersion with AF recurrence after pulmonary vein isolation (PVI). METHODS In a prospective registry of consecutive patients undergoing first PVI, mean EAT attenuation values were measured on contrast-enhanced cardiac CT scans in Hounsfield units (HU) within low (- 195 to - 45 HU) and high (- 44 to - 15 HU) threshold EAT compartments around the left atrium (LA). EAT dispersion was defined as the difference between the mean HU values within the two EAT compartments. Continuous variables were compared between groups using the Mann-Whitney U test and cox proportional hazard models were used to calculate hazard ratios of predictors of 1-year AF recurrence. RESULTS A total of 208 patients were included, 135 with paroxysmal AF and 73 with persistent AF. LA EAT dispersion was significantly larger in patients with persistent compared to paroxysmal AF (52.6 HU vs. 49.9 HU; p = 0.001). After 1 year of follow-up, LA EAT dispersion above the mean (> 50.8 HU) was associated with a higher risk of AF recurrence (HR 2.3, 95% CI 1.5-3.6; p < 0.001). It retained its predictive value when corrected for age, sex, body mass index, LA volume, and AF type (HR 2.8, 95% CI 1.6-4.6; p < 0.001). CONCLUSION A larger LA EAT dispersion on contrast-enhanced cardiac CT scans, reflecting EAT heterogeneity, is independently associated with AF recurrence after PVI. CLINICAL RELEVANCE STATEMENT Based on LA EAT dispersion assessment, a more accurate risk stratification and patient selection may be possible based on a pre-procedural cardiac CT when planning PVI. KEY POINTS • Epicardial adipose tissue (EAT) remodeling is associated with atrial fibrillation (AF). • A larger left atrial EAT dispersion in a pre-procedural cardiac CT was associated with a higher 1-year AF recurrence risk after pulmonary vein isolation. • A pre-procedural cardiac CT with left atrial EAT dispersion assessment may provide a more accurate risk stratification and patient selection for PVI.
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Affiliation(s)
- Adrian Thomas Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
- Department of Radiology and Nuclear Medicine, Lucerne Cantonal Hospital, University of Lucerne, Lucerne, Switzerland, Lucerne, Switzerland.
| | - Severin Fankhauser
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Severin Wittmer
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Laureve Chollet
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Anna Lam
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Jens Maurhofer
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Antonio Madaffari
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Jens Seiler
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Helge Servatius
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Haeberlin
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Fabian Noti
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Brugger
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Hendrik von Tengg-Kobligk
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Hildegard Tanner
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
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Wang Z, Wang Y, Chen J, Ren L, Guo H, Chen X, Dong J, Chen Y, Sun Y. Impact of pericoronary adipose tissue attenuation on recurrence after radiofrequency catheter ablation for atrial fibrillation. Clin Cardiol 2023; 46:1244-1252. [PMID: 37436796 PMCID: PMC10577529 DOI: 10.1002/clc.24081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/03/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Inflammation plays a vital role in the occurrence and progression of atrial fibrillation (AF). The association between pericoronary adipose tissue attenuation (PCATA) and AF recurrence following ablation has not been fully clarified. HYPOTHESIS We aimed to evaluate the association between PCATA and AF recurrence after radiofrequency catheter ablation (RFCA). METHODS Patients who underwent the first RFCA for AF and performed coronary computed tomography angiography before ablation between 2018 and 2021 were enrolled. The predictive values of PCATA for AF recurrence after ablation were investigated. The area under curve (AUC), relative integrated discrimination improvement (IDI), and categorical free net reclassification improvement (NRI) were used to assess the discrimination ability of different models for AF recurrence. RESULTS During 1-year follow-up, 34.1% patients experienced AF recurrence. The multivariable analysis model revealed that PCATA of the right coronary artery (RCA) was an independent risk factor for AF recurrence. Patients with a high level of RCA-PCATA had a high risk of recurrence, after adjusting for other risk factors by restricted cubic splines. The performance in predicting AF recurrence was significantly improved by adding the marker of RCA-PCATA to the clinical model (AUC: 0.724 vs. 0.686, p = .024), with a relative IDI of 0.043 (p = .006) and continuous NRI of 0.521 (p < .001). CONCLUSIONS PCATA of RCA was independently associated with AF recurrence after ablation. PCATA may be helpful for risk classification for AF ablation patients.
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Affiliation(s)
- Zhe Wang
- Department of Cardiology, China‐Japan Friendship HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yi‐Jia Wang
- Department of Cardiology, Beijing HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Jia‐Wei Chen
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina
| | - Li‐Chen Ren
- Department of RadiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - He‐He Guo
- Department of RadiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Xiao‐Jie Chen
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina
| | - Jian‐Zeng Dong
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina
- Department of CardiologyAnzhen Hospital Affiliated to Capital Medical UniversityBeijingChina
| | - Ying‐Wei Chen
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina
| | - Yi‐Hong Sun
- Department of Cardiology, China‐Japan Friendship HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
- Department of CardiologyChina‐Japan Friendship HospitalBeijingChina
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Ma GJ, Guo FQ, Hu J, Liu XW, Chen C, Gao B, Li CY. Association of pericoronary adipose tissue with atrial fibrillation recurrence after ablation based on computed tomographic angiography. Jpn J Radiol 2023; 41:955-964. [PMID: 37040024 DOI: 10.1007/s11604-023-01426-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/02/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE Quantitative measurement of pericoronary adipose tissue volume (PCATV) and fat attenuation index (FAI) has mostly been used in the study of coronary artery related diseases but rarely in the relationship with atrial fibrillation (AF). This study was conducted to investigate the correlation of PCATV and FAI with the AF recurrence after ablation and the clinical significance. MATERIALS AND METHODS Patients with continuous AF who underwent radiofrequency ablation and computed tomographic angiography (CTA) were retrospectively enrolled. The PCATV, FAI, epicardial adipose tissue volume (EATV) and EAT density (EATD) arround the three main branches of the coronary arteries (LAD, LCX, and RCA) were measured quantitatively with cardiac function software and analyzed. RESULTS 189 patients with continuous AF who underwent radiofrequency ablation for the first time were enrolled. After 12-month follow-up with a mean follow-up time of 10.93 ± 0.16 months, 47 (24.9%) patients were confirmed to have AF recurrence. The 3 V-FAI (- 81.17 ± 4.27 vs. - 83.31 ± 4.59 HU, P = 0.005), LCX-FAI (median - 77 vs. median - 81HU, P < 0.001), EATV (median 141.14vs. median 125.39 ml, P = 0.010), and EATVI (median 70.77 vs. 66.73 ml/m2, P = 0.008) were significantly increased in the recurrence group. EATVI (OR 1.043, 95% CI 1.020-1.066) and LCX-FAI (OR 1.254, 95% CI 1.145-1.374) were two significant independent risk factors for AF recurrence. In the comparison of ROC, the predictive value of LCX-FAI (cut-off value of >- 81.5 HU, area under the curve (AUC) of 0.722) was higher than that of EATVI (cut-off value > 81.07 ml/m2, AUC of 0.630). CONCLUSION EATVI and LCX-FAI were related to recurrence of AF after ablation and have important clinical value in predicting the AF recurrence.
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Affiliation(s)
- Guo-Jing Ma
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050011, Hebei Province, China
- Hebei General Hospital, Shijiazhuang, China
| | - Fu-Qian Guo
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050011, Hebei Province, China
| | - Jie Hu
- The Third Hospital of Shijiazhuang City, Shijiazhuang, China
| | - Xiao-Wei Liu
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050011, Hebei Province, China
| | - Chen Chen
- Hebei General Hospital, Shijiazhuang, China
| | - Bulang Gao
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050011, Hebei Province, China
| | - Cai-Ying Li
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050011, Hebei Province, China.
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Shen J, Zhu D, Chen L, Cang J, Zhao Z, Ji Y, Liu S, Miao H, Liu Y, Zhou Q, He Y, Cai J. Relationship between epicardial adipose tissue measured by computed tomography and premature ventricular complexes originating from different sites. Europace 2023; 25:euad102. [PMID: 37083023 PMCID: PMC10228628 DOI: 10.1093/europace/euad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/27/2023] [Indexed: 04/22/2023] Open
Abstract
AIMS This study aims to explore the association between the features of epicardial adipose tissue (EAT) in different zones and premature ventricular complexes (PVCs) originating from different sites by computed tomography (CT). METHODS AND RESULTS A total of 136 patients who underwent radiofrequency ablation for PVCs were incorporated in this study. One hundred and thirty-six matched controls were included in this study using the case-control method (1:1 matching). PVCs were classified into four subgroups: (1) right ventricular outflow tract (RVOT-PVCs), (2) non-RVOT of the right ventricle (RV-PVCs), (3) left ventricular outflow tract (LVOT-PVCs), and (4) non-LVOT of the left ventricle (LV-PVCs). The volume and density of EAT were quantified by CT. Patients with PVCs had a significantly higher volume and lower density of EAT than the controls (P < 0.001). The LVOT-PVCs and LV-PVCs had a higher left ventricle periventricular EAT volume (LV-EATv) proportion (P < 0.05). The right ventricle periventricular EAT volume (RV-EATv) proportion was higher in ROVT-PVCs and LVOT-PVCs (P < 0.05). RVOT-PVC patients had a higher volume ratio and a smaller density differential (P < 0.05). Patients with LVOT-PVCs had a lower volume ratio and the LV-PVCs showed a greater density differential (P < 0.05). CONCLUSION Higher volume and lower density of EAT were significantly associated with frequent PVCs. The RVOT-PVC patients had a higher volume ratio and a smaller density differential. The LVOT-PVCs had a lower volume ratio and the LV-PVCs showed a greater density differential. These suggest a link between EAT structural properties and PVCs and a potential role for regional EAT in the development of PVCs.
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Affiliation(s)
- Junxian Shen
- Department of Cardiology, Zhongda Hospital of Southeast University, Southeast University,Nanjing, China
| | - Didi Zhu
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
| | - Long Chen
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
| | - Jiehui Cang
- Department of Cardiology, Zhongda Hospital of Southeast University, Southeast University,Nanjing, China
| | - Zhen Zhao
- Department of Radiology, Zhongda Hospital of Southeast University, Nanjing, China
| | - Yuqin Ji
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
| | - Shangshang Liu
- Department of Cardiology, Zhongda Hospital of Southeast University, Southeast University,Nanjing, China
| | - Hongyu Miao
- Department of Cardiology, Zhongda Hospital of Southeast University, Southeast University,Nanjing, China
| | - Yaowu Liu
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
| | - Qianxing Zhou
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
| | - Yanru He
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
| | - Junyan Cai
- Department of Cardiology, Zhongda Hospital of Southeast University, Central Gate Street, Gulou District, Nanjing City, Jiangsu Province 210009, China
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