Postoperative atrial fibrillation and atrial epicardial fat: Is there a link?
AF, Atrial Fibrillation
AV, Aortic Valve
BMI, Body Mass Index
BSA, Body Surface Area
CABG, Coronary Artery Bypass Graft
CCTA, Coronary Computed Tomographic Angiography
CM, Contrast Management
CT, Computed Tomography
Cardiac surgery
Computed tomography scan
EAT, Epicardial Adipose Tissue
EAT-V, EAT-Volume
Epicardial adipose tissue
HU, Hounsfield Units
LA, Left Atrial
LAVI, LA Volume Index
LVEF, Left Ventricular Ejection Fraction
MYO, Myocardial
MYO-V, MYO-Volume
POAF, Post-Operative AF
Postoperative atrial fibrillation
ROI, Regions Of Interest
SR, Sinus Rhythm
kV, Kilovoltage
ml, Millilitre
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
29
12
2021
revised:
04
02
2022
accepted:
14
02
2022
entrez:
11
4
2022
pubmed:
12
4
2022
medline:
12
4
2022
Statut:
epublish
Résumé
Atrial Epicardial Adipose Tissue (EAT) is presumably involved in the pathogenesis of atrial fibrillation (AF). The transient nature of postoperative AF (POAF) suggests that surgery-induced triggers provoke an unmasking of a pre-existent AF substrate. The aim is to investigate the association between the volume of EAT and the occurrence of POAF. We hypothesise that the likelihood of developing POAF is higher in patients with high compared to low left atrial (LA) EAT volumes. Quantification of LA EAT based on the Hounsfield Units using custom made software was performed on pre-operative coronary computed tomography angiography scans of patients who underwent cardiac surgery between 2009 and 2019. Patients with mitral valve disease were excluded. A total of 83 patients were included in this study (CABG = 34, aortic valve = 33, aorta ascendens n = 7, combination n = 9), of which 43 patients developed POAF. The EAT percentage in the LA wall nor indexed EAT volumes differed between patients with POAF and with sinus rhythm (all P > 0.05). In multivariable analysis, age and LA volume index (LAVI) were the only independent predictors for early POAF (OR: 1.076 and 1.056, respectively). As expected, advanced age and LAVI were independent predictors of POAF. However, the amount of local EAT was not associated with the occurrence of AF after cardiac surgery. This suggests that the role of EAT in POAF is rather limited, or that the association of EAT in the early phase of POAF is obscured by the dominance of surgical-induced triggers.
Sections du résumé
Background
UNASSIGNED
Atrial Epicardial Adipose Tissue (EAT) is presumably involved in the pathogenesis of atrial fibrillation (AF). The transient nature of postoperative AF (POAF) suggests that surgery-induced triggers provoke an unmasking of a pre-existent AF substrate. The aim is to investigate the association between the volume of EAT and the occurrence of POAF. We hypothesise that the likelihood of developing POAF is higher in patients with high compared to low left atrial (LA) EAT volumes.
Methods
UNASSIGNED
Quantification of LA EAT based on the Hounsfield Units using custom made software was performed on pre-operative coronary computed tomography angiography scans of patients who underwent cardiac surgery between 2009 and 2019. Patients with mitral valve disease were excluded.
Results
UNASSIGNED
A total of 83 patients were included in this study (CABG = 34, aortic valve = 33, aorta ascendens n = 7, combination n = 9), of which 43 patients developed POAF. The EAT percentage in the LA wall nor indexed EAT volumes differed between patients with POAF and with sinus rhythm (all P > 0.05). In multivariable analysis, age and LA volume index (LAVI) were the only independent predictors for early POAF (OR: 1.076 and 1.056, respectively).
Conclusions
UNASSIGNED
As expected, advanced age and LAVI were independent predictors of POAF. However, the amount of local EAT was not associated with the occurrence of AF after cardiac surgery. This suggests that the role of EAT in POAF is rather limited, or that the association of EAT in the early phase of POAF is obscured by the dominance of surgical-induced triggers.
Identifiants
pubmed: 35402690
doi: 10.1016/j.ijcha.2022.100976
pii: S2352-9067(22)00025-2
pmc: PMC8984634
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100976Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors report no relationships that could be construed as a conflict of interest.
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