Sepehri Shamloo Alireza, Dagres Nikolaos, Dinov Boris, Sommer Philipp, Husser-Bollmann Daniella, Bollmann Andreas, Hindricks Gerhard, Arya Arash
Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
Int J Cardiol Heart Vasc. 2019 Jan 26;22:132-138. doi: 10.1016/j.ijcha.2019.01.003. eCollection 2019 Mar.
Although an undoubted association between epicardial fat tissue (EFT) and atrial fibrillation (AF) has been recently approved, the association between EFT and post-ablation AF recurrence is not evident yet. This study aimed to assess the association between EFT and AF recurrence after ablation.
The present study was a systematic review and meta-analysis using related literature available in electronic databases until July 2018 via "atrial fibrillation" and "epicardial fat" as the main keywords. Considering the different methods of EFT measurement, three different pooled meta-analyses were conducted in this study including: 1) comparison of total EFT volume, 2) left atrium (LA)-EFT volume, and 3) EFT thickness between two groups with and without AF recurrence estimating standardized mean difference (SMD) through a random and non-random effect meta-analysis. Statistical analysis was also performed using Comprehensive Meta-analysis (CMA) Software.
Following a search into a total number of 518 articles, the findings of 12 studies published in 10 articles were enrolled in this meta-analysis. Accordingly, the results of meta-analysis showed that LA-EFT and total EFT volumes were higher in recurrent subjects (LA-EFT: SMD = 0.862 ml; I = 0.00, 95% confidence interval (CI) = 0.567-1.156; total EFT: SMD = 1.017 ml, I = 0.00, 95% CI = 0.748-1.286). Besides, a significant higher EFT thickness in patients with AF recurrence compared to those with no AF recurrence was observed (SMD = 0.808 mm, I = 91.07, 95% CI = 0.215-1401).
The total EFT and LA-EFT volumes, as well as EFT thickness, seemed to be associated with AF recurrence in patients undergoing AF ablation.
尽管近期已证实心外膜脂肪组织（EFT）与心房颤动（AF）之间存在明确关联，但EFT与消融术后AF复发之间的关联尚不明确。本研究旨在评估EFT与消融术后AF复发之间的关联。
本研究是一项系统评价和荟萃分析，使用电子数据库中截至2018年7月的相关文献，以“心房颤动”和“心外膜脂肪”作为主要关键词。考虑到EFT测量方法的不同，本研究进行了三种不同的汇总荟萃分析，包括：1）总EFT体积比较；2）左心房（LA）-EFT体积比较；3）有和无AF复发两组之间的EFT厚度比较，通过随机和非随机效应荟萃分析估计标准化平均差（SMD）。还使用综合荟萃分析（CMA）软件进行了统计分析。
在检索的总共518篇文章中，纳入了10篇文章中发表的12项研究的结果进行本荟萃分析。因此，荟萃分析结果显示，复发患者的LA-EFT和总EFT体积更高（LA-EFT：SMD = 0.862 ml；I = 0.00，95%置信区间（CI）= 0.567 - 1.156；总EFT：SMD = 1.017 ml，I = 0.00，95% CI = 0.748 - 1.286）。此外，观察到AF复发患者的EFT厚度显著高于无AF复发患者（SMD = 0.808 mm，I = 91.07，95% CI = 0.215 - 1401）。
总EFT和LA-EFT体积以及EFT厚度似乎与接受AF消融的患者的AF复发有关。
