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

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Thoracic Imaging Pub Date : 2024-11-01 Epub Date: 2024-05-27 DOI:10.1097/RTI.0000000000000789
Yuan Yuan, Yinsu Zhu, Dandan Wu, Jun Wang, Shushen Lin, Yaxin Zhu, Yi Xu, Feiyun Wu
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引用次数: 0

摘要

目的:本研究旨在探讨基于心脏CT的左心房(LA)结构和功能参数以及左心房心外膜脂肪组织(LA-EAT)参数与消融术后房颤(AF)2年内复发的相关性:回顾性分析了2018年6月至2020年6月期间接受初次消融术的286名连续房颤患者(中位年龄:65岁;97名女性)的对比增强心脏CT图像。测量了LA的结构和功能参数,包括LA和左心房阑尾(LAA)的最大和最小容积、射血分数以及LA-EAT容积。计算了体表面积指数化的 LA(LAVImax,LAVImin)和 LAA(LAVImax,LAVImin)最大和最小容积以及 LA-EAT 容积指数(LA-EATVI)。使用 Cox 回归分析确定房颤复发的独立预测因素。临床预测因子与成像预测因子相加,建立一个综合模型(临床+成像)。使用接收者操作特征曲线下面积(AUC)评估临床、影像和组合模型的预测性能:共有 108 名(37.8%)患者在消融术后 2 年内复发房颤,中位随访时间为 24 个月(IQR=11,32)。房颤复发患者的 LA 和 LAA 大小以及 LA-EAT 容积明显增大(PC结论:基于心脏 CT 的 LA-EATVI 和 LAAVImax 是消融术后 2 年内房颤复发的独立预测指标,可为房颤复发风险评估提供补充价值。
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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.

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来源期刊
Journal of Thoracic Imaging
Journal of Thoracic Imaging 医学-核医学
CiteScore
7.10
自引率
9.10%
发文量
87
审稿时长
6-12 weeks
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.
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