Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Siemens Healthineers CT Collaboration, Shanghai, China.
Int J Cardiovasc Imaging. 2022 Aug;38(8):1865-1872. doi: 10.1007/s10554-022-02557-4. Epub 2022 Feb 15.
To assess the association between epicardial adipose tissue (EAT) index derived from cardiac computed tomography and atrial fibrillation (AF) recurrence after ablation by comparing with a propensity score matched non-recurrence AF patients. A total of 506 patients with AF recurrence and 174 patients without AF recurrence were enrolled in this retrospective study. Density and volume of total EAT surrounding the heart (Total-EAT) and EAT surrounding the left atrium (LA-EAT) were measured, propensity score matching(PSM) analyses were used to compare the outcomes of the two groups while controlling for confounders. Total-EAT density (HU) value (-81.27 ± 4.67 vs -84.05 ± 3.84, P < 0.001) and LA-EAT density (HU) value (-76.16 ± 4.11 vs -78.83 ± 3.81, P < 0.001) were significantly higher in the patients with AF recurrence than in those without recurrence. LA-EAT density (HU) value was significantly higher than Total-EAT (- 77.50 ± 4.18 vs -82.66 ± 4.49, P = 0.000). In a multiple logistic regression analysis, a higher LA-EAT density (odds ratio: 1.12; 95% CI: 1.02-1.22, p = 0.015) was significantly associated with the AF recurrence after adjusting for other risk factors. The LA-EAT density plays an important role in the AF recurrence after ablation. Assessment of LA-EAT density can improve ablation outcomes by refining patient selection.
为了评估心脏计算机断层扫描得出的心外膜脂肪组织(EAT)指数与消融后心房颤动(AF)复发之间的相关性，将其与无 AF 复发的倾向评分匹配患者进行比较。本回顾性研究共纳入 506 例 AF 复发患者和 174 例无 AF 复发患者。测量心脏周围总 EAT（Total-EAT）和左心房周围 EAT（LA-EAT）的密度和体积，采用倾向评分匹配（PSM）分析来比较两组在控制混杂因素后的结果。AF 复发组的 Total-EAT 密度（HU）值（-81.27±4.67 比-84.05±3.84，P<0.001）和 LA-EAT 密度（HU）值（-76.16±4.11 比-78.83±3.81，P<0.001）均显著高于无复发组。LA-EAT 密度（HU）值明显高于 Total-EAT（-77.50±4.18 比-82.66±4.49，P=0.000）。多因素逻辑回归分析显示，LA-EAT 密度较高（比值比：1.12；95%置信区间：1.02-1.22，P=0.015）与消融后 AF 复发显著相关，校正其他危险因素后仍有统计学意义。LA-EAT 密度在消融后 AF 复发中起重要作用。评估 LA-EAT 密度可以通过细化患者选择来提高消融效果。
