Zhang Qing-Xue, Liu Zhi-Jian, Liu Xiao-Hong, Zhao Xiao-Hui, Li Xiu-Chang
Department of Echocardiography, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China.
Department of Cardiology, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China.
Rev Cardiovasc Med. 2024 Aug 15;25(8):287. doi: 10.31083/j.rcm2508287. eCollection 2024 Aug.
Recent studies have indicated a close relationship between the thickness of epicardial adipose tissue (EAT) and the occurrence as well as persistence of atrial fibrillation (AF). However, the pathogenesis of this association is still in the exploratory stage. The aim of this study is to explore the correlation EAT, as measured by echocardiography, and P-wave dispersion (Pd) in the context of atrial fibrillation. Additionally, the study seeks to analyze the utility of EAT at different anatomical sites in identifying individuals who are predisposed to atrial fibrillation.
A total of 136 subjects were enrolled and categorized into groups based on the guidelines: paroxysmal atrial fibrillation group (PAF group), persistent atrial fibrillation group (AF group), and non-atrial fibrillation group. Comprehensive clinical data, including general information and medications that could impact the occurrence of atrial fibrillation, were gathered for all patients. Echocardiography was employed to measure the maximum EAT thickness near the apex of the heart on the anterior right ventricular wall and near the base of the right ventricle for each participant. Pd values were computed for each patient based on standard 12-lead synchronous electrocardiogram (ECG). The study involved comparing the disparity in EAT thickness between the two specified sites across the three groups. Additionally, correlation analyses were performed to assess the relationship between EAT thickness at the two sites and Pd. Regression analysis was applied to explore potential risk factors for atrial fibrillation. The diagnostic value of EAT at each site in predicting atrial fibrillation was evaluated using Receiver Operating Characteristic curve (ROC) analysis.
EAT thickness of the anterior wall near the apex of the heart and near the base of the right ventricle were significantly positively correlated with Pd ( 0.05), EAT thickness near the base and left atrial diameter were independent risk factors for atrial fibrillation (OR = 13.673, 95% CI 2.81966.316, = 0.001; OR = 2.294, 95% CI 1.0205.156, = 0.045). ROC analysis showed that the area under the curve of EAT thickness near the heart base was 0.723, and the best threshold for predicting the occurrence of AF was 1.05 cm.
The echocardiography-measured epicardial adipose tissue thickness, particularly in proximity to the heart base, exhibits a significant correlation with Pd. Notably, EAT thickness near the heart base demonstrates superior predictive capability for atrial fibrillation compared to thickness near the apex.
近期研究表明，心外膜脂肪组织（EAT）厚度与心房颤动（AF）的发生及持续存在密切相关。然而，这种关联的发病机制仍处于探索阶段。本研究旨在探讨经超声心动图测量的EAT与心房颤动背景下P波离散度（Pd）之间的相关性。此外，该研究还试图分析不同解剖部位的EAT在识别易患心房颤动个体方面的效用。
共纳入136名受试者，并根据指南进行分组：阵发性心房颤动组（PAF组）、持续性心房颤动组（AF组）和非心房颤动组。收集了所有患者的综合临床数据，包括一般信息和可能影响心房颤动发生的药物。采用超声心动图测量每位参与者右心室前壁心尖附近和右心室基部附近的最大EAT厚度。根据标准12导联同步心电图（ECG）计算每位患者的Pd值。该研究包括比较三组中两个指定部位之间EAT厚度的差异。此外，进行相关性分析以评估两个部位的EAT厚度与Pd之间的关系。应用回归分析来探索心房颤动的潜在危险因素。使用受试者操作特征曲线（ROC）分析评估每个部位的EAT在预测心房颤动方面的诊断价值。
心尖附近前壁和右心室基部附近的EAT厚度与Pd显著正相关（P<0.05），基部附近的EAT厚度和左心房直径是心房颤动的独立危险因素（OR = 13.673，95%CI 2.81966.316，P = 0.001；OR = 2.294，95%CI 1.0205.156，P = 0.045）。ROC分析显示，心底附近EAT厚度的曲线下面积为0.723，预测AF发生的最佳阈值为1.05 cm。
经超声心动图测量的心外膜脂肪组织厚度，尤其是在心底附近，与Pd显著相关。值得注意的是，与心尖附近的厚度相比，心底附近的EAT厚度对心房颤动具有更好的预测能力。
