The Thickness of Epicardial Adipose Tissue Adjacent to the Right Coronary Artery Predicts Recurrence of Atrial Fibrillation After Cryoballoon Ablation: A Simpler Method

IF 0.2 4区医学 Q4 MEDICINE, GENERAL & INTERNAL West Indian Medical Journal Pub Date : 2019-01-01 DOI:10.7727/WIMJ.2017.070

N. S. Yelgeç, S. Şahin, A. Alper

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Abstract

Objective: Epicardial adipose tissue (EAT) is a metabolically active tissue and increased thickness is correlated with various cardiovascular diseases. There are various ways to estimate EAT. In this study, we investigated the predictive value of EAT thickness adjacent to the right coronary artery (RCA) for late atrial fibrillation (AF) recurrences in patients treated with cryoballoon ablation (CBA). We propose that this method is simpler than other methods for measurement of EAT on multidetector computed tomography images. Methods: Patients with symptomatic paroxysmal or persistent AF despite one or more antiarrhythmic drugs who were scheduled for CBA were prospectively recruited. Multidetector computed tomography was performed and epicardial adipose tissue thickness was measured as the fat-thickness from the epicardium to the myocardium around the RCA just after the acute marginal branch. The duration of follow-up was 12 months and AF recurrence was defined as an episode of AF longer than 30 seconds duration occurring three months after CBA. The study population included 72 patients and in 22 patients (30.5%) AF recurrence was observed. Results: Epicardial adipose tissue thickness was significantly higher in patients who had late recurrent AF compared to the patients without late recurrence (12.3 ± 3.2 vs 10.2 ± 3.2, p < 0.01). Highly sensitive C-reactive protein (Hs-CRP) level and left atrial (LA) volume index were significantly higher in the recurrent AF group compared to patients without AF recurrence. Multivariable analysis showed that LA volume index (OR 1.41, 95 % CI:1.15, 1.73, p < 0.01), hs-CRP (OR 1.42, 95% CI:1.02, 1.94, p = 0.04) and EAT thickness (OR 1.34, 95% CI:1.05, 1.71, p = 0.02) remained as independent predictors of AF recurrence in the study population. Conclusion: Epicardial adipose tissue thickness adjacent to the RCA is associated with late AF recurrences in patients treated with CBA. This method of EAT quantification seems to be simpler, less time-consuming and may be an alternative to other methods of EAT measurement.

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右冠状动脉旁心外膜脂肪组织厚度预测低温球囊消融后房颤复发:一种简单的方法

目的:心外膜脂肪组织(EAT)是一种代谢活跃组织，其厚度增加与多种心血管疾病有关。估算EAT的方法有很多。在这项研究中，我们探讨了右冠状动脉(RCA)邻近EAT厚度对低温球囊消融(CBA)患者晚期房颤(AF)复发的预测价值。我们提出这种方法比其他方法更简单，用于测量多检测器计算机断层扫描图像上的EAT。方法:前瞻性招募有症状性阵发性或持续性房颤的患者，尽管有一种或多种抗心律失常药物，但仍计划进行CBA。进行多探测器计算机断层扫描，测量心外膜脂肪组织厚度，即心外膜到RCA周围心肌的脂肪厚度，即在急性边缘分支之后。随访时间为12个月，AF复发定义为CBA后3个月出现AF发作时间超过30秒。研究人群包括72例患者，其中22例(30.5%)出现房颤复发。结果:晚期复发房颤患者心外膜脂肪组织厚度明显高于非晚期复发房颤患者(12.3±3.2 vs 10.2±3.2,p < 0.01)。房颤复发组高敏感c反应蛋白(Hs-CRP)水平和左房容积指数明显高于无房颤复发组。多变量分析显示，LA容积指数(OR 1.41, 95% CI:1.15, 1.73, p < 0.01)、hs-CRP (OR 1.42, 95% CI:1.02, 1.94, p = 0.04)和EAT厚度(OR 1.34, 95% CI:1.05, 1.71, p = 0.02)仍然是研究人群房颤复发的独立预测因子。结论:在接受CBA治疗的患者中，RCA附近的心外膜脂肪组织厚度与房颤晚期复发有关。这种方法似乎更简单，更省时，可以替代其他方法的EAT测量。

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来源期刊

West Indian Medical Journal 医学-医学：内科

CiteScore

0.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal is international in scope, with author and editorial contributions from across the globe. The focus is on clinical and epidemiological aspects of tropical and infectious diseases, new and re-emerging infections, chronic non-communicable diseases, and medical conditions prevalent in the Latin America-Caribbean region, and of significance to global health, especially in developing countries. The Journal covers all medical disciplines, as well as basic and translational research elucidating the pathophysiologic basis of diseases or focussing on new therapeutic approaches, and publishes original scientific research, reviews, case reports, brief communications, letters, commentaries and medical images. The Journal publishes four to six issues and four supplements annually. English is the language of publication but Abstracts are also duplicated in Spanish. Most of the articles are submitted at the authors’ initiative, but some are solicited by the Editor-in-Chief. Unless expressly stated, the Editorial Board does not accept responsibility for authors’ opinions. All papers on submission are reviewed by a subcommittee. Those deemed worthy for review are sent to two or three reviewers (one of the three might be a statistician if necessary). The returned papers with reviewer comments are reviewed by the Editor-in-Chief. Papers may be rejected, accepted or sent back to authors for revision. Resubmitted papers from authors are reviewed by the Editor-in-Chief and may be sent back to reviewers or a final decision made by Editor-in-Chief. The decision of the Editorial Board is final with regards to rejected articles. Rejected articles will not be returned to the authors. The editorial subcommittee has the right to return sub-standard manuscripts to the authors, rather than passing them on to the reviewers. This implies outright rejection of the manuscript.