MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation
BackgroundEpicardial 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 ablatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1045742/full |
| _version_ | 1828299137947271168 |
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| author | Yaacoub Chahine Fima Macheret Karen Ordovas Joonseok Kim Patrick M. Boyle Patrick M. Boyle Patrick M. Boyle Nazem Akoum Nazem Akoum |
| author_facet | Yaacoub Chahine Fima Macheret Karen Ordovas Joonseok Kim Patrick M. Boyle Patrick M. Boyle Patrick M. Boyle Nazem Akoum Nazem Akoum |
| author_sort | Yaacoub Chahine |
| collection | DOAJ |
| description | BackgroundEpicardial 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.MethodsEAT was assessed via the 3D MRI Dixon sequence in 101 patients undergoing AF ablation. Patients were followed for arrhythmia recurrence.ResultsDuring 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).ConclusionEAT quantified using cardiac MRI, a reproducible and widely accessible imaging parameter, is a strong and independent predictor of post-ablation AF recurrence. |
| first_indexed | 2024-04-13T12:51:24Z |
| format | Article |
| id | doaj.art-97df4c8586124f85847f7e8919e81ff6 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T12:51:24Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-97df4c8586124f85847f7e8919e81ff62022-12-22T02:46:12ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-12-01910.3389/fcvm.2022.10457421045742MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablationYaacoub Chahine0Fima Macheret1Karen Ordovas2Joonseok Kim3Patrick M. Boyle4Patrick M. Boyle5Patrick M. Boyle6Nazem Akoum7Nazem Akoum8Division of Cardiology, University of Washington, Seattle, WA, United StatesDivision of Cardiology, University of Washington, Seattle, WA, United StatesDepartment of Radiology, University of Washington, Seattle, WA, United StatesDivision of Cardiology, University of Washington, Seattle, WA, United StatesDepartment of Bioengineering, University of Washington, Seattle, WA, United StatesInstitute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, United StatesCenter for Cardiovascular Biology, University of Washington, Seattle, WA, United StatesDivision of Cardiology, University of Washington, Seattle, WA, United StatesDepartment of Bioengineering, University of Washington, Seattle, WA, United StatesBackgroundEpicardial 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.MethodsEAT was assessed via the 3D MRI Dixon sequence in 101 patients undergoing AF ablation. Patients were followed for arrhythmia recurrence.ResultsDuring 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).ConclusionEAT quantified using cardiac MRI, a reproducible and widely accessible imaging parameter, is a strong and independent predictor of post-ablation AF recurrence.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1045742/fullepicardial adipose tissuecatheter ablationcardiac magnetic resonanceatrial fibrillationDixon sequence |
| spellingShingle | Yaacoub Chahine Fima Macheret Karen Ordovas Joonseok Kim Patrick M. Boyle Patrick M. Boyle Patrick M. Boyle Nazem Akoum Nazem Akoum MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation Frontiers in Cardiovascular Medicine epicardial adipose tissue catheter ablation cardiac magnetic resonance atrial fibrillation Dixon sequence |
| title | MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation |
| title_full | MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation |
| title_fullStr | MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation |
| title_full_unstemmed | MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation |
| title_short | MRI-quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation |
| title_sort | mri quantified left atrial epicardial adipose tissue predicts atrial fibrillation recurrence following catheter ablation |
| topic | epicardial adipose tissue catheter ablation cardiac magnetic resonance atrial fibrillation Dixon sequence |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1045742/full |
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