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Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes

BACKGROUND: There 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...

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Autores principales: Zhu, Jing, Zhuo, Kaimin, Zhang, Bo, Xie, Zhen, Li, Wenjia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234200/
https://www.ncbi.nlm.nih.gov/pubmed/35770221
http://dx.doi.org/10.3389/fcvm.2022.905351
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author Zhu, Jing
Zhuo, Kaimin
Zhang, Bo
Xie, Zhen
Li, Wenjia
author_facet Zhu, Jing
Zhuo, Kaimin
Zhang, Bo
Xie, Zhen
Li, Wenjia
author_sort Zhu, Jing
collection PubMed
description BACKGROUND: There 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). METHODS: In 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. RESULTS: Women 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. CONCLUSION: Women 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.
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spelling pubmed-92342002022-06-28 Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes Zhu, Jing Zhuo, Kaimin Zhang, Bo Xie, Zhen Li, Wenjia Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: There 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). METHODS: In 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. RESULTS: Women 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. CONCLUSION: Women 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. Frontiers Media S.A. 2022-06-13 /pmc/articles/PMC9234200/ /pubmed/35770221 http://dx.doi.org/10.3389/fcvm.2022.905351 Text en Copyright © 2022 Zhu, Zhuo, Zhang, Xie and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Zhu, Jing
Zhuo, Kaimin
Zhang, Bo
Xie, Zhen
Li, Wenjia
Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes
title Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes
title_full Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes
title_fullStr Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes
title_full_unstemmed Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes
title_short Sex Differences in Epicardial Adipose Tissue: Association With Atrial Fibrillation Ablation Outcomes
title_sort sex differences in epicardial adipose tissue: association with atrial fibrillation ablation outcomes
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234200/
https://www.ncbi.nlm.nih.gov/pubmed/35770221
http://dx.doi.org/10.3389/fcvm.2022.905351
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