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Role of epicardial adipose tissue volume as predictor of atrial fibrillation recurrence
Session:
Posters (Sessão 1 - Écran 2) - Arritmias 1 - Fibrilhação Auricular 1
Speaker:
Inês Amorim Cruz
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.2 Atrial Fibrillation - Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Inês Cruz; Sara Lopes; Ricardo Ladeiras-Lopes; Sílvia o. Diaz; Mariana Silva; António s. Barros; Francisca Saraiva; Rita Faria; João Almeida; Paulo Fonseca; Helena Gonçalves; Marco Oliveira; Nuno Ferreira; João Primo; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Background: </span></strong><span style="font-size:11pt">Several studies have demonstrated the relation between general obesity and atrial fibrillation (AF). Epicardial adipose tissue (EAT), due to its local paracrine effect and the intimate relation with the atrium, could influence AF recurrence rates, but very few studies have explored this association. In this study, we aimed to evaluate,</span><span style="font-size:11pt"> if epicardial fat could be a predictor of AF recurrence after an AF ablation procedure.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Methods: </span></strong><span style="font-size:11pt">We included all consecutive patients submitted to AF ablation (2017-2019) who performed a CT scan prior to the procedure. EAT volume was semi-automatically reconstructed by manually tracing the pericardium. Adipose tissue was defined in the range between </span><span style="font-size:11pt">–</span><span style="font-size:11pt">150 and </span><span style="font-size:11pt">–</span><span style="font-size:11pt">50 Hounsfield units. Recurrence was defined as any documented (ECG/Holter) episode of AF, atrial flutter, or atrial tachycardia after 3 months of the procedure. Logistic regression with a restricted cubic polynomial transformation was used to model the non-linear relationship between recurrence and EAT volumes. Inspection of the partial effect curves suggested that a cutoff for EAT volume ≥80mL could stratify patients at risk of recurrence and a Time-to-event analysis was carried.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Results</span></strong><span style="font-size:11pt">: A total of 354 patients (66% male, median age 57 years [IQR 48–65] and 21% persistent AF) were included. <span style="color:black">During a median follow-up of 34 months [IQR 24-43],</span> 117 patients (33%) had AF recurrence. These patients had a significantly greater EAT volume (76 mL [IQR 55-111] vs 72 mL [IQR 48-95], <em>p</em>=0.03) when compared to those without recurrence. Also, patients with higher EAT volume (≥ 80mL) had a higher risk of recurrence compared to patients with lower volume (Figure 1a, log-rank test <em>p</em>=0.007). After adjusting for clinical risk factors (age, gender, hypertension, diabetes, obesity, thyroid disease, AF type and LA enlargement), higher EAT volume did not remain an independent predictor of AF recurrence (Figure 1b, HR 1.25 [95% CI, 0.83-1.86] <em>p</em>=0.3).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt">Conclusion: </span></strong><span style="font-size:11pt">In this cohort of patients with AF submitted to catheter ablation, EAT volume ≥80mL was associated with increased risk of AF recurrence. However, it was not an independent predictor of AF recurrence after adjustment to clinical risk factors.</span></span></span></span></p>
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