Keeran Vickneson, Ali Gharaviri, Vinush Vigneswaran, Johanna Tonko, Neil Bodagh, Magdalena Klis, Irum Kotadia, Matthew Wright, David E Newby, Marc R Dweck, Michelle C Williams, Mark O'Neill, John Whitaker, Steven E Williams
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However, the electrophysiological correlates of both peri-atrial adipose tissue volume and attenuation are unknown.</p><p><strong>Objectives: </strong>This study sought to investigate the spatial relationship between peri-atrial adipose tissue, peri-atrial adipose tissue attenuation, and atrial electrophysiological remodeling.</p><p><strong>Methods: </strong>Cardiac CTA was performed in 37 control subjects and 44 patients with AF. Left atrial bipolar voltage and conduction velocity were co-registered with cardiac CTA-derived peri-atrial adipose tissue segmentations. Mean adipose tissue volume and attenuation were compared with local voltage and conduction velocity measurements.</p><p><strong>Results: </strong>Peri-atrial adipose tissue volume was greater in patients with AF (20.9 cm<sup>3</sup> vs 14.2 cm<sup>3</sup>; adjusted odds ratio: 1.11; 95% CI: 1.01-1.24), independent of left atrial volume indexed to body mass index, left atrial mass, age, sex, sleep apnea, and coronary heart disease. In patients with AF, areas with the highest burden of peri-atrial adipose tissue had lower voltage (1.75 ± 1.72 mV vs 2.11 ± 2.02 mV; P < 0.001) and conduction velocity (0.627 ± 0.55 ms<sup>-1</sup> vs 0.683 ± 0.48 ms<sup>-1</sup>; P < 0.001), compared with areas with the lowest burden of peri-atrial adipose tissue. Mean peri-atrial adipose tissue attenuation was similar in both groups. In patients with AF, low peri-atrial adipose tissue attenuation was weakly correlated with reduced bipolar voltage (1.69 ± 1.68 mV vs 2.16 ± 2.07 mV; P < 0.001) and conduction velocity (0.615 ± 0.47 ms<sup>-1</sup> vs 0.684 ± 0.43 ms<sup>-1</sup>; P < 0.001).</p><p><strong>Conclusions: </strong>Peri-atrial adipose tissue volume was greater in patients with AF. Increased peri-atrial adipose tissue burden and reduced attenuation were spatially but weakly correlated with adverse electrophysiological remodeling in patients with AF.</p>","PeriodicalId":14573,"journal":{"name":"JACC. 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引用次数: 0
摘要
背景：心房周围脂肪组织与心房颤动（AF）有关。在房颤患者中，通过心脏计算机断层血管造影（CTA）检测到心房周围脂肪体积和衰减增加。然而，心房周围脂肪组织体积和衰减的电生理相关性尚不清楚。目的：探讨心房周围脂肪组织、心房周围脂肪组织衰减与心房电生理重构的空间关系。方法：对37例对照组和44例房颤患者进行心脏CTA，左心房双极电压和传导速度与心脏CTA来源的心房周围脂肪组织分割共同登记。比较局部电压和传导速度测量的平均脂肪组织体积和衰减。结果：房颤患者心房周围脂肪组织体积更大(20.9 cm3 vs 14.2 cm3；调整优势比：1.11；95% CI: 1.01-1.24)，与左房容积与体重指数、左房质量、年龄、性别、睡眠呼吸暂停和冠心病无关。房颤患者心房周围脂肪组织负荷最大的区域电压较低（1.75±1.72 mV vs 2.11±2.02 mV）；P < 0.001)和传导速度(0.627±0.55 ms-1 vs 0.683±0.48 ms-1；P < 0.001)，与心房周围脂肪组织负荷最低的区域相比。两组平均心房周围脂肪组织衰减相似。房颤患者心房周围脂肪组织低衰减与双极电压降低呈弱相关(1.69±1.68 mV vs 2.16±2.07 mV；P < 0.001)和传导速度(0.615±0.47 ms-1 vs 0.684±0.43 ms-1；P < 0.001)。结论：房颤患者心房周围脂肪组织体积较大，心房周围脂肪组织负荷增加和衰减减少与房颤患者不良电生理重构具有空间相关性，但相关性较弱。
Peri-Atrial Adipose Tissue Inflammation in Atrial Fibrillation: Quantification of Electrophysiological Effects Using Electroanatomic Mapping.
Background: Peri-atrial adipose tissue is associated with atrial fibrillation (AF). Increased peri-atrial adipose volume and attenuation, detected by cardiac computed tomography angiography (CTA), have been observed in patients with AF. However, the electrophysiological correlates of both peri-atrial adipose tissue volume and attenuation are unknown.
Objectives: This study sought to investigate the spatial relationship between peri-atrial adipose tissue, peri-atrial adipose tissue attenuation, and atrial electrophysiological remodeling.
Methods: Cardiac CTA was performed in 37 control subjects and 44 patients with AF. Left atrial bipolar voltage and conduction velocity were co-registered with cardiac CTA-derived peri-atrial adipose tissue segmentations. Mean adipose tissue volume and attenuation were compared with local voltage and conduction velocity measurements.
Results: Peri-atrial adipose tissue volume was greater in patients with AF (20.9 cm3 vs 14.2 cm3; adjusted odds ratio: 1.11; 95% CI: 1.01-1.24), independent of left atrial volume indexed to body mass index, left atrial mass, age, sex, sleep apnea, and coronary heart disease. In patients with AF, areas with the highest burden of peri-atrial adipose tissue had lower voltage (1.75 ± 1.72 mV vs 2.11 ± 2.02 mV; P < 0.001) and conduction velocity (0.627 ± 0.55 ms-1 vs 0.683 ± 0.48 ms-1; P < 0.001), compared with areas with the lowest burden of peri-atrial adipose tissue. Mean peri-atrial adipose tissue attenuation was similar in both groups. In patients with AF, low peri-atrial adipose tissue attenuation was weakly correlated with reduced bipolar voltage (1.69 ± 1.68 mV vs 2.16 ± 2.07 mV; P < 0.001) and conduction velocity (0.615 ± 0.47 ms-1 vs 0.684 ± 0.43 ms-1; P < 0.001).
Conclusions: Peri-atrial adipose tissue volume was greater in patients with AF. Increased peri-atrial adipose tissue burden and reduced attenuation were spatially but weakly correlated with adverse electrophysiological remodeling in patients with AF.
期刊介绍：
JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.
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