Li Rui, Zhang Jian, Ke Lingling, Zhang Xiaohui, Wu Jiawei, Han Jinsong
Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, Shenyang, Liaoning 110016, China.
Postgraduate Training Base of Northern Theater Command General Hospital, China Medical University, No.83, Wenhua Road, Shenhe District, Shenyang, Liaoning 110016, China.
Int J Cardiol Heart Vasc. 2024 Aug 27;54:101481. doi: 10.1016/j.ijcha.2024.101481. eCollection 2024 Oct.
It is well known that epicardial adipose tissue (EAT) is associated with the development of atrial fibrillation (AF). The aim of this study was to investigate whether EAT density (EAT-d) is associated with the development of new-onset atrial fibrillation (POAF) after aortic valve replacement (AVR).
We retrospectively studied 143 patients who underwent simple AVR at Department of Cardiovascular Surgery of the General Hospital of Northern Theater Command between June 2020 to August 2023. All patients received cardiac coronary artery computed tomography (CT) before surgery. EAT-d, EAT volume and EAT volume index (EATVI) were quantitatively measured and analysed using EAT analysis software (TIMESlicePro). POAF was detected by 7-day Holter monitoring.
Of 143 patients undergoing AVR, 55 patients (38.46 %) developed POAF after surgery. Male patients and patients who had elder age or smoking history were more likely to develop POAF. On univariable analysis, patients developed POAF had significantly more EAT-d (-79.19(-83.91, -74.69) vs. -81.54(-87.16, -76.76); P = 0.043) and EATVI (4.14(3.32,5.03) vs. 3.90(2.70,4.51); P = 0.043) than patients without POAF. On multivariable analysis, EAT-d and age were independent risk factors for POAF (odds ratio (OR): 1.186, 95 % confidence interval (CI): 1.062-1.324, P = 0.002; OR: 1.119, 95 %CI: 1.055-1.187, P < 0.001). Furthermore, EAT-d was significantly associated with age. Furthermore, EAT-d was associated with cardiac structure changes, such as cardiac left ventricular end-diastolic, left ventricular end-systolic volumes and NT-proBNP before surgery.
EAT-d and age are independent predictors of POAF after simple AVR. EAT-d was related with age.
众所周知，心外膜脂肪组织（EAT）与心房颤动（AF）的发生有关。本研究的目的是探讨EAT密度（EAT-d）是否与主动脉瓣置换术（AVR）后新发房颤（POAF）的发生有关。
我们回顾性研究了2020年6月至2023年8月在北部战区总医院心血管外科接受单纯AVR的143例患者。所有患者在手术前均接受了心脏冠状动脉计算机断层扫描（CT）。使用EAT分析软件（TIMESlicePro）对EAT-d、EAT体积和EAT体积指数（EATVI）进行定量测量和分析。通过7天动态心电图监测检测POAF。
在143例接受AVR的患者中，55例（38.46%）术后发生POAF。男性患者以及年龄较大或有吸烟史的患者更易发生POAF。单因素分析显示，发生POAF的患者术前EAT-d（-79.19（-83.91，-74.69）对-81.54（-87.16，-76.76）；P=0.043）和EATVI（4.14（3.32，5.03）对3.90（2.70，4.51）；P=0.043）显著高于未发生POAF的患者。多因素分析显示，EAT-d和年龄是POAF的独立危险因素（比值比（OR）：1.186，95%置信区间（CI）：1.062-1.324，P=0.002；OR：1.119，95%CI：1.055-1.187，P<0.001）。此外，EAT-d与年龄显著相关。此外，EAT-d与心脏结构变化有关，如术前心脏左心室舒张末期、左心室收缩末期容积和NT-proBNP。
EAT-d和年龄是单纯AVR术后POAF的独立预测因素。EAT-d与年龄有关。
