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Association between epicardial adipose tissue and recurrence of atrial fibrillation after ablation: a propensity score-matched analysis

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Abstract

To assess the association between epicardial adipose tissue (EAT) index derived from cardiac computed tomography and atrial fibrillation (AF) recurrence after ablation by comparing with a propensity score matched non-recurrence AF patients. A total of 506 patients with AF recurrence and 174 patients without AF recurrence were enrolled in this retrospective study. Density and volume of total EAT surrounding the heart (Total-EAT) and EAT surrounding the left atrium (LA-EAT) were measured, propensity score matching(PSM) analyses were used to compare the outcomes of the two groups while controlling for confounders. Total-EAT density (HU) value (-81.27 ± 4.67 vs -84.05 ± 3.84, P < 0.001) and LA-EAT density (HU) value (-76.16 ± 4.11 vs -78.83 ± 3.81, P < 0.001) were significantly higher in the patients with AF recurrence than in those without recurrence. LA-EAT density (HU) value was significantly higher than Total-EAT (− 77.50 ± 4.18 vs -82.66 ± 4.49, P = 0.000). In a multiple logistic regression analysis, a higher LA-EAT density (odds ratio: 1.12; 95% CI: 1.02–1.22, p = 0.015) was significantly associated with the AF recurrence after adjusting for other risk factors. The LA-EAT density plays an important role in the AF recurrence after ablation. Assessment of LA-EAT density can improve ablation outcomes by refining patient selection.

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Funding

(1) Shanghai Rising Stars of Medical Talent Youth Development Program, Youth Medical Talents—Medical Imaging Practitioner Program: SHWRS(2020)_087. (2) Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai—Youth Medical Talents: GWV-10.2-YQ30. (3) Shanghai Sailing Program. (4) Natural Science Foundation of China under Grant: 8217070113.

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Authors and Affiliations

  1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Min Yang, Wenrui Bao, Le Qin, Ning Zhang, Fuhua Yan & Wenjie Yang

  2. Siemens Healthineers CT Collaboration, Shanghai, China

    Zhihan Xu

  3. Department of Cardiovascular Medicine, Ruijin Hospital, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Ning Zhang

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  1. Min Yang
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  6. Fuhua Yan
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  7. Wenjie Yang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MY, WB, ZX, LQ and NZh. Conceptualization, resources, and methodology were performed by WY, and FY. The first draft of the manuscript was written by MY. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Wenjie Yang.

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The authors declare that they have no conflict of interest.

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The approval for this study had been granted by the local Institutional Review board prior to its conduct and informed consent was waived. The study therefore had been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. No patient identifiers were collected, and details that might disclose the identity of the subjects under study should were omitted.

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Yang, M., Bao, W., Xu, Z. et al. Association between epicardial adipose tissue and recurrence of atrial fibrillation after ablation: a propensity score-matched analysis. Int J Cardiovasc Imaging 38, 1865–1872 (2022). https://doi.org/10.1007/s10554-022-02557-4

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