Usefulness of Epicardial Adipose Tissue Volume to Predict Recurrent Atrial Fibrillation After Radiofrequency Catheter Ablation
Usefulness of Epicardial Adipose Tissue Volume to Predict Recurrent Atrial Fibrillation After Radiofrequency Catheter Ablation
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DOI：
10.1016/j.amjcard.2018.08.005
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发表时间：
2018-11-15
影响因子：
2.8
通讯作者：
Shimabukuro, Michio
中科院分区：
文献类型：
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作者：
Maeda, Minetaka;Oba, Kageyuki;Shimabukuro, Michio
尽管越来越多的证据表明心外膜脂肪组织体积 (EATV) 与消融后心房颤动 (AF) 相关，但预测消融后 AF 复发的 EATV 范围仍不清楚。在本研究中，我们评估了：(1) EATV 与 AF 特征之间的关系，(2) EATV 对射频消融后复发性 AF 的影响；(3) 使用受试者工作特征曲线来评估复发性 AF 的截止点。在 218 名连续接受 AF 消融治疗的有症状患者中（143 名阵发性 AF；78 名持续性 AF），使用 320 排多排计算机断层扫描测量 EATV 指数（EATVI：EATV/体表面积，mL/m(2)）。高 EATV 组表现出特定的心脏代谢紊乱以及左心房扩张和左心室功能障碍。多变量回归分析表明，EATVI 是导管消融后 AF 复发的独立预测因子。高 EATV (EATVI >= 85 mL/m(2)) 或 EATVI 截止值 >= 116 mL/m(2) 可以预测导管消融后房颤复发，独立于其他危险因素。总之，EATVI 是导管消融后 AF 复发的独立预测因子；高 EATV 三分位数或 EATVI 截止值可能有助于预测导管消融后房颤复发。未来的研究应确定 EATVI 在 AF 消融临床环境中的效用。 (C) 2018 Elsevier Inc. 保留所有权利。
Although increasing evidence suggests that epicardial adipose tissue volume (EATV) is associated with post-ablation atrial fibrillation (AF), ranges of EATV predictive of post ablation recurrence of AF remain unclear. In this study, we evaluated: (1) relationships between EATV and characteristics of AF, (2) impact of EATV on recurrent AF after radiofrequency ablation;, and (3) cut-off point for recurrent AF using a receiver operating characteristic curve. In 218 consecutive symptomatic patients undergoing who underwent ablation for AF (143 paroxysmal AF; 78 persistent AF), the EATV index (EATVI: EATV/body surface area, mL/m(2)) was measured using 320-row multidetector computed tomography. The high EATV group showed specific cardiometabolic derangements as well as left atrial dilatation and left ventricular dysfunction. Multivariate regression analysis showed that the EATVI was an independent predictor of recurrent AF after catheter ablation. High EATV (EATVI >= 85 mL/m(2)) or EATVI cutoff >= 116 mL/m(2) can predict recurrent AF after catheter ablation, independent of other risk factors. In conclusion, EATVI was an independent predictor of recurrent AF after catheter ablation; a high EATV tertile or EATVI cutoff may be useful for prediction of recurrent AF after catheter ablation. Future studies should determine the utility of the EATVI in the clinical setting of AF ablation. (C) 2018 Elsevier Inc. All rights reserved.