Yu Wenji, Wang Chunbo, Yue Yue, Sun Fan, Wan Peng, Shao Shan, Zhang Feifei, Shao Xiaoliang, Shi Yunmei, Liu Bao, Wang Jianfeng, Yang Minfu, Li Sijin, Wang Yuetao
Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Institute of Clinical Translation of Nuclear Medicine and Molecular Imaging, Soochow University, Changzhou, China.
Quant Imaging Med Surg. 2024 Dec 5;14(12):8294-8307. doi: 10.21037/qims-24-728. Epub 2024 Oct 18.
Recent studies have shown that resting amygdalar activity is associated with cardiovascular disease. Nevertheless, the underlying mechanisms that link resting amygdalar activity with persistent atrial fibrillation (PerAF) remain to be comprehensively delineated. We aimed to estimate the association between resting amygdalar activity, right atrium (RA) inflammatory activity, and PerAF.
In the retrospective cohort study, F-fluorodeoxyglucose positron emission tomography-computed tomography (F-FDG-PET/CT) imaging was performed in 104 patients with AF between January 1, 2018, and December 31, 2022 in the third Affiliated Hospital of Soochow University. Clinical data, electrocardiograms, echocardiographic assessments, and cardiac F-FDG uptake measurements were systematically gathered. Validated methodologies were employed to assess resting amygdalar activity, right atrium target:background ratio (RATBR), and bone-marrow activity (BMA). Associations between resting amygdalar activity and PerAF were assessed via a logistic regression model and mediation (path) analyses.
Among the patients included, 60 (57.7%) had PerAF. Compared with patients with paroxysmal AF (ParAF), those with PerAF had higher resting amygdalar activity (1.11±0.16 1.47±0.27), BMA (1.66±0.48 2.12±0.65), and RATBR (1.55±0.36 2.31±0.73) (all P values <0.001). Resting amygdalar activity demonstrated a statistically significant correlation with BMA (r=0.38; P<0.001) and RATBR (r=0.44; P<0.001). BMA significantly mediated the associations between resting amygdalar activity and RATBR, accounting for 50.2% [95% confidence interval (CI): 35.8-76.7%] of this association. Resting amygdalar activity and RATBR emerged as the sole independent variable for PerAF (odds ratio =6.81; 95% CI: 2.34-19.75; P<0.001; odds ratio =9.01; 95% CI: 3.04-26.70; P<0.001). Mediation analysis suggested that RATBR significantly mediated the associations between resting amygdalar activity and PerAF, accounting for 33.2% (95% CI: 16.6-52.4%) of this association.
Resting amygdalar activity and RATBR evaluated by PET/CT were significantly associated with PerAF. The association of testing amygdalar activity with PerAF was in part mediated by RA inflammatory activity, which could be a potential therapeutic target for PerAF. Further prospective research is needed to determine the generalizability of these findings.
最近的研究表明，静息杏仁核活动与心血管疾病有关。然而，将静息杏仁核活动与持续性心房颤动（PerAF）联系起来的潜在机制仍有待全面阐明。我们旨在评估静息杏仁核活动、右心房（RA）炎症活动与PerAF之间的关联。
在这项回顾性队列研究中，2018年1月1日至2022年12月31日期间，苏州大学附属第三医院对104例房颤患者进行了F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG-PET/CT）成像。系统收集了临床数据、心电图、超声心动图评估和心脏F-FDG摄取测量值。采用经过验证的方法评估静息杏仁核活动、右心房靶本比（RATBR）和骨髓活动（BMA）。通过逻辑回归模型和中介（路径）分析评估静息杏仁核活动与PerAF之间的关联。
在纳入的患者中，60例（57.7%）患有PerAF。与阵发性房颤（ParAF）患者相比，PerAF患者的静息杏仁核活动（1.11±0.16对1.47±0.27）、BMA（1.66±0.48对2.12±0.65）和RATBR（1.55±0.36对2.31±0.73）更高（所有P值<0.001）。静息杏仁核活动与BMA（r=0.38；P<0.001）和RATBR（r=0.44；P<0.001）具有显著的统计学相关性。BMA显著介导了静息杏仁核活动与RATBR之间的关联，占该关联的50.2%[95%置信区间（CI）：35.8-76.7%]。静息杏仁核活动和RATBR是PerAF的唯一独立变量（比值比=6.81；95%CI：2.34-19.75；P<0.001；比值比=9.01；95%CI：3.04-26.70；P<0.001）。中介分析表明，RATBR显著介导了静息杏仁核活动与PerAF之间的关联，占该关联的33.2%（95%CI：16.6-52.4%）。
PET/CT评估的静息杏仁核活动和RATBR与PerAF显著相关。杏仁核活动检测与PerAF的关联部分由RA炎症活动介导，这可能是PerAF的一个潜在治疗靶点。需要进一步的前瞻性研究来确定这些发现的普遍性。
