Radiomic phenotype of epicardial adipose tissue in the prognosis of atrial fibrillation recurrence after catheter ablation in patients with lone atrial fibrillation

Abstract

Background Epicardial adipose tissue (EAT) has been considered as one of the probable triggers of atrial fibrillation (AF). CT‐rediomics is a perspective noninvasive method of assessment of EAT. We evaluate the radiomic phenotype of EAT in patients with lone AF in the prognosis of AF recurrence after catheter ablation. Methods A total of 43 patients with lone AF referred for CA and 20 out‐hospital patients without arrhythmia underwent multidetector computed tomography coronary angiography. Segmentation of EAT and extraction radiomic features were performed on calcium scoring series using by 3D‐Slicer. Clinical follow‐up was performed for 12 months period after the CA. Results EAT in patients with lone AF had a distinct radiomic phenotype. Thus, 45 of 93 calculated radiomic features, volume and attenuation of EAT were significantly different between patients with lone AF and persons without any arrhythmia. In addition, 17 radiomic features were significantly different in subgroups with and without AF recurrence. Multivariate regression analysis demonstrated that only gray level nonuniformity normalized (GLSZM) was an independent predictor of AF recurrence (OR 1.0027, 95%CI 1.0009–1.0044, p = 0.002). ROC analysis data showed that GLSZM >1227.4 indicates high probability of AF recurrence during 12 months (sensitivity 89.4%, specificity 70.8%, AUC: 0.809; p = 0.001). Conclusion The radiomic parameter GLSZM is associated with late AF recurrence after CA in patients with lone AF. In current study GLSZM was a stronger predictor of lone AF recurrence in multivariate analysis comparing with other established risk factors and EAT volume and attenuation.

The role of epicardial adipose tissue dysfunction in cardiovascular diseases: an overview of pathophysiology, evaluation, and management

“…In another study, most of the persistent AF patients who are not anticoagulated and with increased periatrial EAT thickness were also associated with an increased risk of cardiovascular events ( 74 ). Julia and colleagues found that patients with lone AF have larger volume and higher attenuation of EAT compared with patients without cardiac arrhythmias ( 75 ). Moreover, non-uniformity of EAT radiomic gray level is the only independent predictor of post-ablation AF recurrence within 12 months follow-up ( 75 ).…”

“…Julia and colleagues found that patients with lone AF have larger volume and higher attenuation of EAT compared with patients without cardiac arrhythmias ( 75 ). Moreover, non-uniformity of EAT radiomic gray level is the only independent predictor of post-ablation AF recurrence within 12 months follow-up ( 75 ).…”

Epicardial adipose tissue, metabolic disorders, and cardiovascular diseases: recent advances classified by research methodologies

“…Moreover, lower EAT attenuation levels indicating a higher lipid component is also associated with AF recurrence 105,106 . In addition, recent studies have demonstrated a significant difference in the radiomics phenotype of EAT between patients with lone AF and the control group, and even between different AF subtypes 107,108 . Furthermore, some specific radiomics features, such as Gray‐Level Size Zone Matrix, can act as an independent predictor of AF recurrence, which might be of practical clinical value in AF management 108,109 …”

Recent assessment methods of epicardial adipose tissue

“…Ilyushenkova и соавт. (2022) [26] продемонстрировали, что у больных с изолированной фибрилляцией предсердий (ФП) 45 из 93 рассчитанных рентгенологических признаков, объем и затухание ЭЖТ достоверно различались между пациентами с изолированной ФП и лицами без аритмии. При многофакторном регрессионном анализе в подгруппах пациентов с рецидивом и без рецидива ФП только нормированная неоднородность уровня серого (gray level nonuniformity normalized -GLSZM) была независимым предиктором рецидива ФП (ОШ 1,0027; 95% ДИ 1,0009-1,0044; р = 0,002).…”