Association of epicardial adipose tissue density with postoperative atrial fibrillation after isolated aortic valve replacement

Backgrounds

It is well known that epicardial adipose tissue (EAT) is associated with the development of atrial fibrillation (AF). The aim of this study was to investigate whether EAT density (EAT-d) is associated with the development of new-onset atrial fibrillation (POAF) after aortic valve replacement (AVR).

Methods

We retrospectively studied 143 patients who underwent simple AVR at Department of Cardiovascular Surgery of the General Hospital of Northern Theater Command between June 2020 to August 2023. All patients received cardiac coronary artery computed tomography (CT) before surgery. EAT-d, EAT volume and EAT volume index (EATVI) were quantitatively measured and analysed using EAT analysis software (TIMESlicePro). POAF was detected by 7-day Holter monitoring.

Results

Of 143 patients undergoing AVR, 55 patients (38.46 %) developed POAF after surgery. Male patients and patients who had elder age or smoking history were more likely to develop POAF. On univariable analysis, patients developed POAF had significantly more EAT-d (−79.19(−83.91, −74.69) vs. −81.54(−87.16, −76.76); P = 0.043) and EATVI (4.14(3.32,5.03) vs. 3.90(2.70,4.51); P = 0.043) than patients without POAF. On multivariable analysis, EAT-d and age were independent risk factors for POAF (odds ratio (OR): 1.186, 95 % confidence interval (CI): 1.062–1.324, P = 0.002; OR: 1.119, 95 %CI: 1.055–1.187, P < 0.001). Furthermore, EAT-d was significantly associated with age. Furthermore, EAT-d was associated with cardiac structure changes, such as cardiac left ventricular end-diastolic, left ventricular end-systolic volumes and NT-proBNP before surgery.

Conclusion

EAT-d and age are independent predictors of POAF after simple AVR. EAT-d was related with age.