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The predictive value of epicardial adipose tissue volume assessed by cardiac magnetic resonance for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy

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Abstract

Atrial fibrillation (AF) is the most common arrhythmia and potentially increase the risk of embolic stroke and aggravate progressive heart failure in patients with hypertrophic cardiomyopathy (HCM). Recent studies demonstrated that epicardial adipose tissue (EAT) was closely associated with AF in general population. However, the relationship between EAT and AF in HCM patients remains unclear. A total of 93 consecutive patients with hypertrophic obstructive cardiomyopathy (HOCM) at Fuwai Hospital were enrolled in our study. There were 18 patients with AF and 75 patients without it. Cardiac magnetic resonance (CMR) imaging was performed in all participants. EAT volume (EATV) and left atrial volume (LAV) were determined by E-3D medical model software. HOCM patients with AF had significantly greater EATV index (EATVI, P < 0.001), LAV index (LAVI, P < 0.001) and left ventricular end-systole volume index (LVESVI, P = 0.039), and lower left ventricular ejection fraction (LVEF, P = 0.002). In multivariable logistic regression analysis, EATVI, LAVI, and LVEF remained independent determinants of AF occurrence (OR = 1.023, 95% CI, 1.003–1.043, P = 0.023, OR = 1.043, 95% CI, 1.012–1.075, P = 0.006, and OR = 0.887, 95% CI, 0.818–0.962, P = 0.004, respectively). Furthermore, receiver operating characteristic (ROC) curve analysis demonstrated that integration of EATVI, LAVI and LVEF provided better discriminatory performance for incident AF in HOCM patients with a high sensitivity of 94.4% and a specificity of 69.3% (AUC = 0.864, 95% CI, 0.771–0.958, P < 0.001). EATVI is an independent predictor of the presence of AF, and integration of EATVI, LVEF and LAVI determined by CMR provide greater discriminatory performance for identifying AF in HOCM patients.

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According to the management system of Fuwai Hospital, we are not allowed to share original research data publicly.

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Acknowledgements

We thank Shenghui Liao (Central South University, Changsha, China) for offer of E-3D medical model software.

Funding

This work was supported by National Key Research and Development Program of China (No. 2018YFB1107102).

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Author notes

  1. Yue Zhou and Miao Yu are equally contributed to manuscript.

Authors and Affiliations

  1. Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China

    Yue Zhou, Miao Yu, Jingang Cui, Fenghuan Hu, Zhuoxuan Yang, Jiansong Yuan & Shubin Qiao

  2. Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China

    Yue Zhou

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  1. Yue Zhou
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Correspondence to Jiansong Yuan or Shubin Qiao.

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Approval of Ethics Committee of Fuwai Hospital was acquired at the beginning of the study.

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Zhou, Y., Yu, M., Cui, J. et al. The predictive value of epicardial adipose tissue volume assessed by cardiac magnetic resonance for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy. Int J Cardiovasc Imaging 37, 1383–1393 (2021). https://doi.org/10.1007/s10554-020-02092-0

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