Yuan Yuan, Yinsu Zhu, Dandan Wu, Jun Wang, Shushen Lin, Yaxin Zhu, Yi Xu, Feiyun Wu
{"title":"基于心脏 CT 的左心房结构和心外膜脂肪组织与消融术后两年内心房颤动复发的关系","authors":"Yuan Yuan, Yinsu Zhu, Dandan Wu, Jun Wang, Shushen Lin, Yaxin Zhu, Yi Xu, Feiyun Wu","doi":"10.1097/RTI.0000000000000789","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to explore the association of cardiac CT-based left atrium (LA) structural and functional parameters and left atrial epicardial adipose tissue (LA-EAT) parameters with postablation atrial fibrillation (AF) recurrence within 2 years.</p><p><strong>Materials and methods: </strong>Contrast-enhanced cardiac CT images of 286 consecutive AF patients (median age: 65 y; 97 females) who underwent initial ablation between June 2018 and June 2020 were retrospectively analyzed. Structural and functional parameters of LA, including maximum and minimum volume and ejection fraction of LA and left atrial appendage (LAA), and LA-EAT volume, were measured. The body surface area indexed maximum and minimum volume of LA (LAVI max , LAVI min ) and LAA (LAAVI max , LAAVI min ), and LA-EAT volume index (LA-EATVI) were calculated. Independent predictors of AF recurrence were determined using Cox regression analysis. The clinical predictors were added to the imaging predictors to build a combined model (clinical+imaging). The predictive performance of the clinical, imaging, and combined models was assessed using the area under the receiver operating characteristics curve (AUC).</p><p><strong>Results: </strong>A total of 108 (37.8%) patients recurred AF within 2 years after ablation at a median follow-up of 24 months (IQR=11, 32). LA and LAA size and LA-EAT volume were significantly increased in patients with AF recurrence ( P <0.05). After the multivariable regression analysis, LA-EATVI, LAAVI max , female sex, AF duration, and stroke history were independent predictors for AF recurrence. The combined model exhibited superior predictive performance compare to the clinical model (AUC=0.712 vs. 0.641, P =0.023) and the imaging model (AUC=0.712 vs. 0.663, P =0.018).</p><p><strong>Conclusion: </strong>Cardiac CT-based LA-EATVI and LAAVI max are independent predictors for postablation AF recurrence within 2 years and may provide a complementary value for AF recurrence risk assessment.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":"351-358"},"PeriodicalIF":2.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Relationship Between Cardiac CT-based Left Atrial Structure and Epicardial Adipose Tissue and Postablation Atrial Fibrillation Recurrence Within 2 Years.\",\"authors\":\"Yuan Yuan, Yinsu Zhu, Dandan Wu, Jun Wang, Shushen Lin, Yaxin Zhu, Yi Xu, Feiyun Wu\",\"doi\":\"10.1097/RTI.0000000000000789\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The aim of this study was to explore the association of cardiac CT-based left atrium (LA) structural and functional parameters and left atrial epicardial adipose tissue (LA-EAT) parameters with postablation atrial fibrillation (AF) recurrence within 2 years.</p><p><strong>Materials and methods: </strong>Contrast-enhanced cardiac CT images of 286 consecutive AF patients (median age: 65 y; 97 females) who underwent initial ablation between June 2018 and June 2020 were retrospectively analyzed. Structural and functional parameters of LA, including maximum and minimum volume and ejection fraction of LA and left atrial appendage (LAA), and LA-EAT volume, were measured. The body surface area indexed maximum and minimum volume of LA (LAVI max , LAVI min ) and LAA (LAAVI max , LAAVI min ), and LA-EAT volume index (LA-EATVI) were calculated. Independent predictors of AF recurrence were determined using Cox regression analysis. The clinical predictors were added to the imaging predictors to build a combined model (clinical+imaging). The predictive performance of the clinical, imaging, and combined models was assessed using the area under the receiver operating characteristics curve (AUC).</p><p><strong>Results: </strong>A total of 108 (37.8%) patients recurred AF within 2 years after ablation at a median follow-up of 24 months (IQR=11, 32). LA and LAA size and LA-EAT volume were significantly increased in patients with AF recurrence ( P <0.05). After the multivariable regression analysis, LA-EATVI, LAAVI max , female sex, AF duration, and stroke history were independent predictors for AF recurrence. The combined model exhibited superior predictive performance compare to the clinical model (AUC=0.712 vs. 0.641, P =0.023) and the imaging model (AUC=0.712 vs. 0.663, P =0.018).</p><p><strong>Conclusion: </strong>Cardiac CT-based LA-EATVI and LAAVI max are independent predictors for postablation AF recurrence within 2 years and may provide a complementary value for AF recurrence risk assessment.</p>\",\"PeriodicalId\":49974,\"journal\":{\"name\":\"Journal of Thoracic Imaging\",\"volume\":\" \",\"pages\":\"351-358\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Thoracic Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/RTI.0000000000000789\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Thoracic Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RTI.0000000000000789","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
The Relationship Between Cardiac CT-based Left Atrial Structure and Epicardial Adipose Tissue and Postablation Atrial Fibrillation Recurrence Within 2 Years.
Purpose: The aim of this study was to explore the association of cardiac CT-based left atrium (LA) structural and functional parameters and left atrial epicardial adipose tissue (LA-EAT) parameters with postablation atrial fibrillation (AF) recurrence within 2 years.
Materials and methods: Contrast-enhanced cardiac CT images of 286 consecutive AF patients (median age: 65 y; 97 females) who underwent initial ablation between June 2018 and June 2020 were retrospectively analyzed. Structural and functional parameters of LA, including maximum and minimum volume and ejection fraction of LA and left atrial appendage (LAA), and LA-EAT volume, were measured. The body surface area indexed maximum and minimum volume of LA (LAVI max , LAVI min ) and LAA (LAAVI max , LAAVI min ), and LA-EAT volume index (LA-EATVI) were calculated. Independent predictors of AF recurrence were determined using Cox regression analysis. The clinical predictors were added to the imaging predictors to build a combined model (clinical+imaging). The predictive performance of the clinical, imaging, and combined models was assessed using the area under the receiver operating characteristics curve (AUC).
Results: A total of 108 (37.8%) patients recurred AF within 2 years after ablation at a median follow-up of 24 months (IQR=11, 32). LA and LAA size and LA-EAT volume were significantly increased in patients with AF recurrence ( P <0.05). After the multivariable regression analysis, LA-EATVI, LAAVI max , female sex, AF duration, and stroke history were independent predictors for AF recurrence. The combined model exhibited superior predictive performance compare to the clinical model (AUC=0.712 vs. 0.641, P =0.023) and the imaging model (AUC=0.712 vs. 0.663, P =0.018).
Conclusion: Cardiac CT-based LA-EATVI and LAAVI max are independent predictors for postablation AF recurrence within 2 years and may provide a complementary value for AF recurrence risk assessment.
期刊介绍:
Journal of Thoracic Imaging (JTI) provides authoritative information on all aspects of the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Original articles and analytical reviews published in this timely journal provide the very latest thinking of leading experts concerning the use of chest radiography, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and all other promising imaging techniques in cardiopulmonary radiology.
Official Journal of the Society of Thoracic Radiology:
Japanese Society of Thoracic Radiology
Korean Society of Thoracic Radiology
European Society of Thoracic Imaging.