Association between epicardial adipose tissue imaging characteristics and left atrial appendage thrombus in patients with atrial fibrillation

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-08-04 DOI:10.1016/j.ijcha.2025.101765

Chengyi Li , Chengchen Zhao , Bing Wu , Fandong Zhu , Chen Yang , Buyun Xu

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引用次数: 0

Abstract

Aim

To explore the epicardial adipose tissue (EAT) characteristics associated with left atrial appendage thrombus (LAAT) in patients with atrial fibrillation (AF).

Methods

This 1:1 individual-match (by age, sex, CHA₂DS₂-VASc score, and anticoagulant use) study respectively enrolled 95 pairs of patients, comparing those with and without LAAT. EAT parameters derived from cardiac computed tomography angiography (CTA)—including volume, mean CT attenuation (CTmean), and radiomic features—were extracted and analyzed for their association with LAAT.

Results

On contrast-enhanced CT, the mean CT attenuation of EAT was significantly higher in patients with LAAT than in those without at both 1 mm (median [IQR]: −75 [−88 to − 71] vs. − 71 [−86 to − 65.5], P < 0.01) and 3 mm (median [IQR]: −81 [−83.5 to − 78] vs. − 74 [−77.5 to − 72], P < 0.01) from the LAA boundary. However, no significant difference was observed at 5 mm (median [IQR]: −87 [−90 to − 85] vs. − 86 [−89 to − 83], P > 0.05). Relative EAT volume was not significantly associated with LAAT. Eight radiomic features were selected using least absolute shrinkage and selection operator (LASSO) regression to generate a radiomics score. The radiomics score was significant associated with LAAT, independent of clinical characteristics and traditional CT parameters of EAT.

Conclusion

Imaging characteristics of EAT surrounding the LAA in patients with AF, particularly increased mean CT attenuation and radiomic features, were found to be associated with the presence of LAAT.

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心房颤动患者心外膜脂肪组织成像特征与左房附件血栓的关系

目的探讨心房颤动（AF）患者左房附件血栓（LAAT）的心外膜脂肪组织（EAT）特征。方法采用1:1的个体配对（按年龄、性别、CHA2DS2-VASc评分和抗凝剂使用）研究，分别入组95对患者，比较LAAT组和未LAAT组。从心脏计算机断层血管造影（CTA）得到的EAT参数——包括体积、平均CT衰减（CTmean）和放射学特征——被提取并分析它们与LAAT的关系。结果在CT增强扫描中，LAAT患者的平均CT衰减在1 mm处均显著高于无LAAT患者(中位[IQR]:−75[−88 ~−71]vs.−71[−86 ~−65.5],P <；(0.01)和3毫米(差)中位数:81−[83.5−−78]与−74(72−−77.5),P & lt;0.01)。然而，在5毫米处未观察到显著差异(中位数[IQR]: - 87[- 90至- 85]对- 86[- 89至- 83]，P >；0.05)。相对EAT量与LAAT无显著相关。使用最小绝对收缩和选择算子（LASSO）回归选择八个放射组学特征以生成放射组学评分。放射组学评分与LAAT显著相关，独立于临床特征和传统CT参数。结论AF患者LAAT周围的EAT影像学特征与LAAT的存在有关，尤其是平均CT衰减和放射学特征的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.