Journal of magnetic resonance imaging : JMRI · 2024
The Association of Epicardial Adipose Tissue Volume and Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: As Assessed by Cardiac MR.
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Li Chensi, Yu Honglin, Li Yuguo, Deng Wei, Jia Zhuoran, Xue Yangcheng, Wang Zhen, Xu Huimin, Yu Yongqiang, Zhao Ren, Han Yuchi, Zhu Yinsu, Li Xiaohu
Аннотация
BACKGROUND: Epicardial adipose tissue (EAT) is a metabolically active visceral fat linked to cardiovascular disease. Prior studies demonstrated the predictive value of EAT volume (EATV) in atrial fibrillation (AF) among hypertrophic obstructive cardiomyopathy patients.
PURPOSE: To investigate the association between EATV and AF in hypertrophic cardiomyopathy (HCM).
STUDY TYPE: Retrospective.
POPULATION: Two hundred and twenty-four HCM patients (including 79 patients with AF and 145 patients without AF, 154 men) and 80 healthy controls (54 men).
FIELD STRENGTH/SEQUENCE: 3.0 T scanner; balanced steady-state free precession (SSFP) cine sequence, gradient echo.
ASSESSMENT: EAT thickness was assessed in the 4-chamber and basal short-axis planes. EAT volume was calculated by outlining the epicardial border and visceral pericardium layer on short-axis cine images.
STATISTICAL TESTS: Shapiro-Wilk test, Student's t test or the Mann-Whitney U test, chi-square test or Fisher's exact test, Multivariate linear regression analyses, Multivariable binary logistic regression analysis. Intraclass correlation coefficient. Significance was determined at P < 0.05.
RESULTS: EATV and EAT volume index (EATVI) were significantly greater in HCM patients with AF than those without AF (126.6 ± 25.9 mL vs. 90.5 ± 24.5 mL, and 73.0 ± 15.9 mL/m2 vs. 51.3 ± 13.4 mL/m2). EATVI was associated with AF in multivariable linear regression analysis among HCM patients (β = 0.62). Multivariable logistic regression analysis revealed that compared to other indicators, the area under curve (AUC) of EATVI was 0.86 (cut-off, 53.9 mL/m2, 95% CI, 0.80-0.89), provided a better performance, with the sensitivity of 96.2% and specificity of 58.6%. The combined model exhibited superior association with AF presence compared to the clinical model (AUC 0.96 vs. 0.76) and the imaging model (AUC 0.96 vs. 0.93).
DATA CONCLUSION: EATVI was associated with AF. EATVI was significantly correlated with incident AF, and provided a better performance in HCM patients compared to other indicators.
EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.
PURPOSE: To investigate the association between EATV and AF in hypertrophic cardiomyopathy (HCM).
STUDY TYPE: Retrospective.
POPULATION: Two hundred and twenty-four HCM patients (including 79 patients with AF and 145 patients without AF, 154 men) and 80 healthy controls (54 men).
FIELD STRENGTH/SEQUENCE: 3.0 T scanner; balanced steady-state free precession (SSFP) cine sequence, gradient echo.
ASSESSMENT: EAT thickness was assessed in the 4-chamber and basal short-axis planes. EAT volume was calculated by outlining the epicardial border and visceral pericardium layer on short-axis cine images.
STATISTICAL TESTS: Shapiro-Wilk test, Student's t test or the Mann-Whitney U test, chi-square test or Fisher's exact test, Multivariate linear regression analyses, Multivariable binary logistic regression analysis. Intraclass correlation coefficient. Significance was determined at P < 0.05.
RESULTS: EATV and EAT volume index (EATVI) were significantly greater in HCM patients with AF than those without AF (126.6 ± 25.9 mL vs. 90.5 ± 24.5 mL, and 73.0 ± 15.9 mL/m2 vs. 51.3 ± 13.4 mL/m2). EATVI was associated with AF in multivariable linear regression analysis among HCM patients (β = 0.62). Multivariable logistic regression analysis revealed that compared to other indicators, the area under curve (AUC) of EATVI was 0.86 (cut-off, 53.9 mL/m2, 95% CI, 0.80-0.89), provided a better performance, with the sensitivity of 96.2% and specificity of 58.6%. The combined model exhibited superior association with AF presence compared to the clinical model (AUC 0.96 vs. 0.76) and the imaging model (AUC 0.96 vs. 0.93).
DATA CONCLUSION: EATVI was associated with AF. EATVI was significantly correlated with incident AF, and provided a better performance in HCM patients compared to other indicators.
EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.