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Association between epicardial adipose tissue volume and recurrence of atrial fibrillation after catheter ablation
Session:
Comunicações Orais - Sessão 12 - Fibrilhação Auricular: Novas Perspetivas sobre os Mecanismos
Speaker:
Bárbara Lacerda Teixeira
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.9 Atrial Fibrillation - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Bárbara Lacerda Teixeira; Pedro Silva Cunha; Ana Sofia Jacinto; Guilherme Portugal; Bruno Valente; Ana Lousinha; Madalena Coutinho Cruz; Ana Sofia Delgado; Manuel Bras; Margarida Paulo; Cátia Guerra; Ruben Ramos; Ilária Fontes; Rui Cruz Ferreira; Mário Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Introduction:</span></span></span></strong> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">In patients </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">(pts) </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">undergoing </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">catheter </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">ablation </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">of </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">atrial fibrillation (AF), up to one third </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">have arrhythmia recurrence </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">after a first ablation. Epicardial adipose tissue (EAT)</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> secretes proinflammatory adipokines, and has been considered to be </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">closely related to AF</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">, with a potential </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">role in the recurrence of AF after catheter ablation.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Objectives: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">To </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">evaluate the association between the volume of EAT measured by cardiac angio-CT and arrhythmia recurrence in pts </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">submitted to </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">catheter ablation of AF.</span></span></span><br /> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Methods: </strong>Single-center retrospective study of consecutive AF pts submitted to </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">ablation </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">between 20</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">11</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> and 2020</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">, with, at least, one-year follow-up.</span></span></span> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Epidemiological, clinical, laboratory, echocardiography and angio-CT related data were retrieved.</span></span></span> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">A standardized protocol for quantification of EAT, thoracic adipose volume (TAV) and left atrium volume (LAV) was performed.</span></span></span> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">After comparison of groups using Chi-square and Mann-Whitney analysis, an </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">appropriate Cut</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">-</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Off </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">of EAT </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">for our population </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">was determined using ROC Curve, </span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">and</span></span></span> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Kaplan Meier survival curves were used to estimate the risk of events</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"> (recurrence of AF).</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Results: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">344 pts (63,1% men) were included, with a mean age of 57.4±10.9 years and a median follow-up time of 22 months. During follow-up, 31,7% (n=109) had recurrence of AF. Baseline characteristics were similar between groups, except for persistent AF, which was higher in pts with recurrence (25% vs. 46%, p=0,011). AF recurrence was associated with higher EAT (p=0,040) and higher LAV (p<0.001), but not with TAV (p=0,115) nor body mass index (BMI) (p=0,123). In pts with AF recurrence, values of EAT above a cut-off of 151cm3 predicted the endpoint of time to recurrence (HR 2,05, IC [1,180 – 3,566], p=0.01), with pts presenting a median of 11 months survival free from recurrence, compared to a median of 15 months in those with EAT values bellow the aforementioned cut-off (log-rank p=0.008). </span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Conclusion: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">EAT may serve as a predictor of AF recurrence after ablation, with pts showing an EAT volume > 151cm3 presenting a statistically significant lower survival free from recurrence.</span></span></span></span></span></span></p>
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