Department of Radiology, Hainan Hospital of PLA General Hospital, 572000 Sanya, China.
The Second School of Clinical Medicine, Southern Medical University, 510145 Guangzhou, China.
Br J Radiol. 2024 Feb 2;97(1154):341-352. doi: 10.1093/bjr/tqad046.
Fat radiomic profile (FRP) was a promising imaging biomarker for identifying increased cardiac risk. We hypothesize FRP can be extended to fat regions around pulmonary veins (PV), left atrium (LA), and left atrial appendage (LAA) to investigate their usefulness in identifying atrial fibrillation (AF) and the risk of AF recurrence.
We analysed 300 individuals and grouped patients according to the occurrence and types of AF. We used receiver operating characteristic and survival curves analyses to evaluate the value of imaging biomarkers, including fat attenuation index (FAI) and FRP, in distinguishing AF from sinus rhythm and predicting post-ablation recurrence.
FRPs from AF-relevant fat regions showed significant performance in distinguishing AF and non-AF with higher AUC values than FAI (peri-PV: FRP = 0.961 vs FAI = 0.579, peri-LA: FRP = 0.923 vs FAI = 0.575, peri-LAA: FRP = 0.900 vs FAI = 0.665). FRPs from peri-PV, peri-LA, and peri-LAA were able to differentiate persistent and paroxysmal AF with AUC values of 0.804, 0.819, and 0.694. FRP from these regions improved AF recurrence prediction with an AUC of 0.929, 0.732, and 0.794. Patients with FRP cut-off values of ≥0.16, 0.38, and 0.26 had a 7.22-, 5.15-, and 4.25-fold higher risk of post-procedure recurrence, respectively.
FRP demonstrated potential in identifying AF, distinguishing AF types, and predicting AF recurrence risk after ablation. FRP from peri-PV fat depot exhibited a strong correlation with AF. Therefore, evaluating epicardial fat using FRP was a promising approach to enhance AF clinical management.
The role of epicardial adipose tissue (EAT) in AF had been confirmed, we focussed on the relationship between EAT around pulmonary arteries and LAA in AF which was still unknown. Meanwhile, we used the FRP to excavate more information of EAT in AF.
脂肪放射组学特征（FRP）是一种有前途的成像生物标志物，可用于识别心脏风险增加。我们假设 FRP 可以扩展到肺静脉（PV）、左心房（LA）和左心耳（LAA）周围的脂肪区域，以研究它们在识别房颤（AF）和 AF 复发风险中的作用。
我们分析了 300 名个体，并根据 AF 的发生和类型对患者进行分组。我们使用接收者操作特征和生存曲线分析来评估成像生物标志物（包括脂肪衰减指数（FAI）和 FRP）在区分 AF 与窦性节律和预测消融后复发中的价值。
来自与 AF 相关的脂肪区域的 FRP 在区分 AF 和非 AF 方面表现出显著的性能，其 AUC 值高于 FAI（PV 周围：FRP=0.961 与 FAI=0.579，LA 周围：FRP=0.923 与 FAI=0.575，LAA 周围：FRP=0.900 与 FAI=0.665）。来自 PV 周围、LA 周围和 LAA 周围的 FRP 能够区分持续性和阵发性 AF，AUC 值分别为 0.804、0.819 和 0.694。来自这些区域的 FRP 改善了 AF 复发预测，AUC 值分别为 0.929、0.732 和 0.794。FRP 截断值≥0.16、0.38 和 0.26 的患者术后复发的风险分别为 7.22、5.15 和 4.25 倍。
FRP 显示出在识别 AF、区分 AF 类型和预测消融后 AF 复发风险方面的潜力。PV 周围脂肪库中的 FRP 与 AF 具有很强的相关性。因此，使用 FRP 评估心外膜脂肪是一种有前途的增强 AF 临床管理的方法。
已经证实心外膜脂肪组织（EAT）在 AF 中的作用，我们专注于 AF 中仍然未知的肺动脉和 LAA 周围 EAT 之间的关系。同时，我们使用 FRP 挖掘 AF 中 EAT 的更多信息。
