Department of Cardiovascular Medicine, CHU Lille, F-59000, Lille, France.
Univ Lille, F-59000, Lille, France.
Eur Radiol. 2019 Jun;29(6):3027-3035. doi: 10.1007/s00330-018-5793-4. Epub 2018 Nov 6.
To evaluate whether the epicardial adipose tissue (EAT) phenotype is associated with the electrophysiological properties of adjacent atrial myocardium in patients with atrial fibrillation (AF).
Between January and May 2017, 30 consecutive patients referred for a first AF catheter ablation were prospectively included. For each patient, a pre-procedural computed tomography scan was performed to assess total and left atrial (LA) EAT amount and radiodensity. A detailed point-by-point voltage mapping using an electroanatomic mapping system was realized to assess the presence of LA low-voltage zone (LVZ).
Ten patients (33.3%) presented at least one LVZ. Older age (65 ± 7 vs. 58 ± 10 years, p = 0.05) was the only clinical parameter associated with LVZ. Despite no greater LA-EAT thickness by CT scan (3.0 [2.6-3.5] mm vs. 2.8 [2.2-3.1] mm, p = 0.354), patients with LA-LVZ presented significantly lower LA-EAT radiodensity than patients with no LA-LVZ (- 101.8 ± 12.5 HU vs. - 90.4 ± 6.3 HU, p = 0.004). No difference between total-EAT volume (131 ± 61 cm vs.107 ± 58 cm, p = 0.361) and total-EAT radiodensity (- 106.8 ± 4.3 HU vs. - 102.4 ± 6.9 HU, p = 0.119) was found.
Low LA-EAT radiodensity is associated with the presence of LVZ in patients with medical history of AF.
• Cardiovascular risk factors are associated with low adipose tissue computed tomography attenuation. • Epicardial adipose tissue (EAT) has emerged as an important factor in the pathogenesis of metabolic-related cardiac diseases such as atrial fibrillation. • We showed that low left atrial EAT attenuation is associated with the presence of low-voltage zone, a surrogate for atrial fibrosis, within the adjacent myocardium.
评估心外膜脂肪组织（EAT）表型是否与房颤（AF）患者心房心肌的电生理特性相关。
2017 年 1 月至 5 月，前瞻性纳入 30 例因首次房颤导管消融而就诊的连续患者。对每位患者进行术前 CT 扫描，以评估总 EAT 和左心房（LA）EAT 量和放射密度。使用电解剖图谱系统进行详细的逐点电压映射，以评估 LA 低电压区（LVZ）的存在。
10 例患者（33.3%）至少存在一个 LVZ。年龄较大（65±7 岁 vs. 58±10 岁，p=0.05）是唯一与 LVZ 相关的临床参数。尽管 CT 扫描显示 LA-EAT 厚度无明显增加（3.0[2.6-3.5]mm vs. 2.8[2.2-3.1]mm，p=0.354），但存在 LA-LVZ 的患者 LA-EAT 放射密度明显低于无 LA-LVZ 的患者（-101.8±12.5 HU vs. -90.4±6.3 HU，p=0.004）。总-EAT 体积（131±61 cm vs. 107±58 cm，p=0.361）和总-EAT 放射密度（-106.8±4.3 HU vs. -102.4±6.9 HU，p=0.119）无差异。
在有房颤病史的患者中，LA-EAT 放射密度低与 LVZ 的存在相关。
• 心血管危险因素与脂肪组织 CT 衰减降低相关。• 心外膜脂肪组织（EAT）已成为代谢相关心脏疾病（如房颤）发病机制中的重要因素。• 我们发现，左心房 EAT 衰减值低与邻近心肌内低电压区（LVZ，心房纤维化的替代指标）的存在相关。
