Dataset Information

Epicardial adipose tissue is associated with higher recurrence risk after catheter ablation in atrial fibrillation patients: a systematic review and meta-analysis.

ABSTRACT:

Objective

Our study aimed to investigate the association between epicardial adipose tissue (EAT) and atrial fibrillation (AF) recurrence risk after catheter ablation.

Methods

We searched PubMed, Embase, and Cochrane Library databases up to November 30, 2021 without language restrictions. Outcome was the relative risk (RR) of EAT contributes to AF recurrence after catheter ablation. The RR and 95% confidence interval (CI) was pooled by the random-effect model.

Results

10 studies that contained 1840 AF patients were included in our study. The result of this study showed that EAT amount was associated with higher risk of AF recurrence after catheter ablation (RR = 1.06, 95% CI 1.02-1.11, P = 0.005) and EAT related thickness was a risk factor for AF recurrence after catheter ablation (RR = 1.73, 95% CI 1.04-2.87, P = 0.040). Sub-analysis showed that EAT was strongly associated with higher risk of AF recurrence common in Asian population (RR = 1.25, 95% CI 1.10-1.43, P < 0.001), patients aged ≤ 60 years old (RR = 2.01, 95% CI 1.18-3.44, P = 0.010), and follow-up more than 1 year (RR = 1.06, 95% CI 1.01-1.11, P = 0.020).

Conclusion

The meta-analysis demonstrated that EAT related thickness seems to be the marker most strongly associated with a greater risk of AF recurrences after catheter ablation. It should be included into risk stratification for predicting AF recurrent before catheter ablation.

SUBMITTER: Chen J

PROVIDER: S-EPMC9188706 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Epicardial adipose tissue is associated with higher recurrence risk after catheter ablation in atrial fibrillation patients: a systematic review and meta-analysis.

Chen Jun J Mei Ziwei Z Yang Yang Y Dai Chuxing C Wang Yimin Y Zeng Rui R Liu Qiang Q

BMC cardiovascular disorders 20220611 1

<h4>Objective</h4>Our study aimed to investigate the association between epicardial adipose tissue (EAT) and atrial fibrillation (AF) recurrence risk after catheter ablation.<h4>Methods</h4>We searched PubMed, Embase, and Cochrane Library databases up to November 30, 2021 without language restrictions. Outcome was the relative risk (RR) of EAT contributes to AF recurrence after catheter ablation. The RR and 95% confidence interval (CI) was pooled by the random-effect model.<h4>Results</h4>10 stu ...[more]

PMID: 35690712

Similar Datasets

Project description:BackgroundThere are significant differences in the prevalence and prognosis of atrial fibrillation (AF) between sexes. Epicardial adipose tissue (EAT) has been found as a risk factor for AF. This study aimed to evaluate whether sex-based EAT differences were correlated with AF recurrence and major adverse cardiovascular events (MACE).MethodsIn this study, postmenopausal women and age, BMI, and type of AF matched men who had received first catheter ablation were included. EAT volume was quantified based on the pre-ablation cardiac computed tomography (CT) images. Clinical, CT, and echocardiographic variables were compared by sex groups. The predictors of AF recurrence and MACE were determined through Cox proportional hazards regression.ResultsWomen were found with significantly lower total EAT volumes (P < 0.001) but higher periatrial/total (P/T) EAT ratios (P = 0.009). The median follow-up duration was 444.5 days. As revealed by the result of the Kaplan-Meier survival analysis, the women were found to have a significantly higher prevalence of AF recurrence (log rank, P = 0.011) but comparable MACE (log rank, P = 0.507) than men. Multivariate analysis demonstrated that female gender (HR: 1.88 [95% CI: 1.03, 4.15], P = 0.032), persistent AF (HR: 2.46 [95% CI: 1.19, 5.05], P = 0.015), left atrial (LA) dimension (HR: 1.47 [95% CI: 1.02, 2.13], P = 0.041), and P/T EAT ratio (HR: 1.73 [95% CI: 1.12, 2.67], P = 0.013) were found as the independent predictors of AF recurrence. Sex-based subgroup multivariable analysis showed that the P/T EAT ratio was an independent predictor of AF recurrence in both men (HR: 1.13 [95% CI: 1.01, 1.46], P = 0.047) and women (HR: 1.37 [95% CI: 1.11, 1.67], P = 0.028). While age (HR: 1.81 [95% CI: 1.18, 2.77], P = 0.007), BMI (HR: 1.44 [95% CI: 1.02, 2.03], P = 0.038), and periatrial EAT volume (HR: 1.31 [95% CI: 1.01, 1.91], P = 0.046) were found to be independent of MACE.ConclusionWomen had a higher P/T EAT ratio and AF post-ablation recurrence but similar MACE as compared with men. Female gender and P/T EAT ratio were found to be independent predictors of AF recurrence, whereas age and periatrial EAT volume were found to be independent predictors of MACE.

Project description:BackgroundRadiofrequency catheter ablation (RFCA) represents an important treatment option for atrial fibrillation (AF); however, the recurrence rate following surgery is relatively high. This study aimed to predict the recurrence of AF after RFCA using interpretable machine learning models that combined the triglyceride-glucose (TyG) index and the quantification of left atrial epicardial and pericoronary adipose tissue.MethodsThis retrospective study included 325 patients with AF who underwent their first successful RFCA, among whom 79 had confirmed recurrence. The preoperative clinical data of patients were collected, the TyG index was calculated, and computed tomography (CT) image features were quantitatively measured. Multivariate Cox regression analysis was used to identify the independent risk factors for RFCA recurrence, and adjustments being made for various confounding factors. Post-hoc subgroup analysis was conducted to evaluate the predictive value of the TyG index for recurrence in different patient subgroups. Prediction models based on six machine learning algorithms were constructed. The optimal model's features were evaluated using Shapley additive explanations (SHAP).ResultsAfter adjustment were made for various confounding factors such as comorbidities of AF, Cox regression showed that the volume of left atrial epicardial adipose tissue (LA-EAT), LA-EAT attenuation, left circumflex coronary artery fat attenuation index (LCX-FAI), and the TyG index were independent risk factors for recurrence after RFCA (P<0.001). The support vector machine (SVM) model based on these combined indicators had the best predictive performance, with an area under the curve of 0.793 [95% confidence interval (CI): 0.782-0.805] in the validation set, while its accuracy and positive predictive value were 0.804 and 0.710, respectively. The predictive efficiency of the TyG index appeared to be independent of type 2 diabetes mellitus (T2DM) status (Pinteraction=0.660).ConclusionsThe SVM model that integrated the TyG index and quantitative CT imaging variables demonstrated good predictive ability for post-RFCA recurrence in patients with AF. Furthermore, the TyG index appeared capable of predicting recurrence independently of T2DM status.

Dataset Information

Epicardial adipose tissue is associated with higher recurrence risk after catheter ablation in atrial fibrillation patients: a systematic review and meta-analysis.

Objective

Methods

Results

Conclusion

Publications

Epicardial adipose tissue is associated with higher recurrence risk after catheter ablation in atrial fibrillation patients: a systematic review and meta-analysis.

Similar Datasets

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