MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation.
MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation.
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DOI：
10.3389/fcvm.2022.1045742
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发表时间：
2022
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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心外膜脂肪组织（EAT）在促进心房颤动（AF）中起重要作用，由于其促炎特性和解剖上接近心肌。我们试图评估导管消融后左房（LA） EAT容量是否与房颤复发相关。通过三维MRI Dixon序列对101例房颤消融患者的EAT进行评估。随访患者心律失常复发情况。在平均1年的随访期间，消融后房颤复发31例（30.7%）。复发组LA EAT指数高于无复发组（20.7[16.9,30.4]比13.7 [10.5,20.1]mL/m2, p < 0.001）， LA容积指数也高于无复发组（66[52.6,77.5]比49.9 [37.7,61.8]mL/m2, p = 0.001）。Cox回归分析显示，LA EAT （HR = 1.089; 95% CI: [1.049-1.131], p < 0.001）是房颤消融后复发的独立预测因子。LA EAT指数预测房颤复发的ROC曲线AUC为0.77 (95% CI 0.68-0.86, p < 0.001)，最佳截断值为14.29 mL/m2，可识别消融后房颤复发风险患者。将LA EAT与临床危险因素相结合可改善AF复发预测（AUC从0.65增加到0.79，DeLong检验p = 0.044）。Kaplan-Meier无复发生存率分析显示，两组患者的最佳LA EAT指数截止值为14.29 mL/m2，差异有统计学意义（log rank = 14.79; p < 0.001）。使用心脏MRI量化EAT，这是一种可重复且可广泛获取的成像参数，是消融后房颤复发的强大且独立的预测因子。
Epicardial adipose tissue (EAT) plays a significant role in promoting atrial fibrillation (AF) due to its proinflammatory properties and anatomic proximity to the myocardium. We sought to assess whether left atrial (LA) EAT volume is associated with AF recurrence following catheter ablation. EAT was assessed via the 3D MRI Dixon sequence in 101 patients undergoing AF ablation. Patients were followed for arrhythmia recurrence. During an average follow-up period of 1 year, post-ablation AF recurrence occurred in 31 (30.7%) patients. LA EAT index was higher in those with compared to without recurrence (20.7 [16.9, 30.4] vs. 13.7 [10.5, 20.1] mL/m2, p < 0.001), and so was LA volume index (66 [52.6, 77.5] vs. 49.9 [37.7, 61.8] mL/m2, p = 0.001). Cox regression analysis showed LA EAT (HR = 1.089; 95% CI: [1.049–1.131], p < 0.001) to be an independent predictor of post-ablation AF recurrence. The ROC curve for LA EAT index in the prediction of AF recurrence had an AUC of 0.77 (95% CI 0.68–0.86, p < 0.001) and showed an optimal cutoff value of 14.29 mL/m2 to identify patients at risk of post-ablation AF recurrence. Integrating LA EAT with clinical risk factors improved prediction of AF recurrence (AUC increased from 0.65 to 0.79, DeLong test p = 0.044). Kaplan-Meier analysis for recurrence-free survival showed a significant difference between two groups of patients identified by the optimal LA EAT index cutoff of 14.29 mL/m2 (log rank = 14.79; p < 0.001). EAT quantified using cardiac MRI, a reproducible and widely accessible imaging parameter, is a strong and independent predictor of post-ablation AF recurrence.
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影响因子：
5.8
作者：
Sacks, Harold S.;Fain, John N.;Symonds, Michael E.
通讯作者：
Symonds, Michael E.
DOI：
10.1007/s10840-016-0130-9
发表时间：
2016-11-01
影响因子：
1.8
作者：
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通讯作者：
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2
作者：
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通讯作者：
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影响因子：
7
作者：
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通讯作者：
Sanders, Prashanthan
影响因子：
2.8
作者：
Harada, Ken;Amano, Tetsuya;Murohara, Toyoaki
通讯作者：
Murohara, Toyoaki