The relationship between epicardial adipose tissue and premature ventricular contractions originating from different areas in the right ventricular outflow tract: A cross-sectional study

ObjectiveThis study aimed to investigate the association between Epicardial adipose tissue (EAT) and premature ventricular contractions (PVCs) originating from different regions within the right ventricular outflow tract (RVOT).MethodsPatients with PVCs originating from RVOT undergoing catheter ablation from January 2022 to June 2024 were retrospectively enrolled in this study. Based on actual mapping results, patients were categorized into two groups: RVOT septum and RVOT free wall. The volume and density of EAT were quantified using routine chest CT images. Furthermore, patients were stratified into subgroups by sex, age, and body mass index (BMI) to further compare the relationship between EAT and PVC in different populations.ResultsA total of 127 PVC patients were enrolled: 77 with septal RVOT origin and 50 with free-wall origin. Patients in the RVOT free wall group exhibited significantly higher volumes of total EAT and RV EAT compared to the RVOT septum group (<i>P</i> = 0.021; <i>P</i> = 0.040). No significant differences in EAT density were observed between the two groups. Subgroup analyses revealed that female patients and those with BMI < 23 in the free wall PVC group had larger RV EAT volume and total EAT volume than their counterparts with septum PVCs. However, this difference was not observed in male patients or higher BMI subgroups.ConclusionsEAT may exhibit greater pathogenicity in PVCs originating from the RVOT free wall, particularly in female and low BMI patients.