{"title":"肥厚型心肌病患者心外膜脂肪组织体积与心房颤动的关系：心脏磁共振评估","authors":"Chensi Li, Honglin Yu, Yuguo Li, Wei Deng, Zhuoran Jia, Yangcheng Xue, Zhen Wang, Huimin Xu, Yongqiang Yu, Ren Zhao, Yuchi Han, Yinsu Zhu, Xiaohu Li","doi":"10.1002/jmri.29525","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>To investigate the association between EATV and AF in hypertrophic cardiomyopathy (HCM).</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>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).</p><p><strong>Field strength/sequence: </strong>3.0 T scanner; balanced steady-state free precession (SSFP) cine sequence, gradient echo.</p><p><strong>Assessment: </strong>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.</p><p><strong>Statistical tests: </strong>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.</p><p><strong>Results: </strong>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/m<sup>2</sup> vs. 51.3 ± 13.4 mL/m<sup>2</sup>). 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/m<sup>2</sup>, 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).</p><p><strong>Data conclusion: </strong>EATVI was associated with AF. EATVI was significantly correlated with incident AF, and provided a better performance in HCM patients compared to other indicators.</p><p><strong>Evidence level: </strong>3 TECHNICAL EFFICACY: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Association of Epicardial Adipose Tissue Volume and Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: As Assessed by Cardiac MR.\",\"authors\":\"Chensi Li, Honglin Yu, Yuguo Li, Wei Deng, Zhuoran Jia, Yangcheng Xue, Zhen Wang, Huimin Xu, Yongqiang Yu, Ren Zhao, Yuchi Han, Yinsu Zhu, Xiaohu Li\",\"doi\":\"10.1002/jmri.29525\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>To investigate the association between EATV and AF in hypertrophic cardiomyopathy (HCM).</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Population: </strong>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).</p><p><strong>Field strength/sequence: </strong>3.0 T scanner; balanced steady-state free precession (SSFP) cine sequence, gradient echo.</p><p><strong>Assessment: </strong>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.</p><p><strong>Statistical tests: </strong>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.</p><p><strong>Results: </strong>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/m<sup>2</sup> vs. 51.3 ± 13.4 mL/m<sup>2</sup>). 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/m<sup>2</sup>, 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).</p><p><strong>Data conclusion: </strong>EATVI was associated with AF. EATVI was significantly correlated with incident AF, and provided a better performance in HCM patients compared to other indicators.</p><p><strong>Evidence level: </strong>3 TECHNICAL EFFICACY: Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29525\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29525","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
背景：心外膜脂肪组织（EAT心外膜脂肪组织（EAT）是一种代谢活跃的内脏脂肪，与心血管疾病有关。目的：研究肥厚型梗阻性心肌病（HCM）患者心外膜脂肪组织体积（EATV）与心房颤动之间的关系：研究类型：回顾性：224 名 HCM 患者（包括 79 名房颤患者和 145 名无房颤患者，154 名男性）和 80 名健康对照者（54 名男性）：3.0 T 扫描仪；平衡稳态自由前序 (SSFP) cine 序列，梯度回波：在四腔和基底短轴平面评估EAT厚度。通过在短轴电影图像上勾画心外膜边界和内脏心包层来计算EAT体积：Shapiro-Wilk 检验、学生 t 检验或 Mann-Whitney U 检验、卡方检验或费雪精确检验、多变量线性回归分析、多变量二元逻辑回归分析。类内相关系数。显著性以 P 结果为准：有房颤的 HCM 患者的 EATV 和 EAT 容积指数（EATVI）明显高于无房颤的患者（126.6 ± 25.9 mL vs. 90.5 ± 24.5 mL，73.0 ± 15.9 mL/m2 vs. 51.3 ± 13.4 mL/m2）。在 HCM 患者的多变量线性回归分析中，EATVI 与房颤相关（β = 0.62）。多变量逻辑回归分析显示，与其他指标相比，EATVI 的曲线下面积（AUC）为 0.86（临界值为 53.9 mL/m2，95% CI，0.80-0.89），具有更好的性能，灵敏度为 96.2%，特异性为 58.6%。与临床模型（AUC 0.96 vs. 0.76）和成像模型（AUC 0.96 vs. 0.93）相比，综合模型与房颤存在的相关性更优：数据结论：EATVI 与房颤相关。数据结论：EATVI 与房颤相关，与其他指标相比，EATVI 与房颤事件明显相关，在 HCM 患者中的表现更好。
The Association of Epicardial Adipose Tissue Volume and Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: As Assessed by Cardiac MR.
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.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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