Epicardial adipose tissue volume is associated with prevalent atrial fibrillation in patients undergoing cardiac CT angiography: a retrospective observational case-control study

Abstract Background Atrial fibrillation (AF) is the most prevalent tachyarrhythmia in clinical practice and carries significant risks of disability and mortality. Epicardial adipose tissue (EAT) contributes to the development of AF owing to its proinflammatory characteristics and anatomical proximity to the myocardium. Purpose To explore the correlation between the epicardial adipose tissue volume (EATV) and AF and its clinical value by cardiac computed tomographic angiography (CCTA). Methods A total of 75 AF patients were enrolled and divided into 2 groups: paroxysmal AF group (n=46) and persistent AF group (n=29), there were 41 males and 34 females, with an average age of 60.17±9.85 years; In addition, 78 cases with sinus rhythm were also enrolled as control group, there were 43 males and 35 females, with an average age of 59.93±10.49 years. All enrolled patients received 256-slice spiral CCTA scanning, EATV and pericardial adipose tissue volume (PATV) were measured using cardiac function software in workstation, and basic information of all cases were recorded. EATV and other clinical data were compared between the AF group and the control group. EATV, PATV and other clinical data were further analyzed between the paroxysmal AF group and persistent AF group. Results AF group had higher EATV compared with control group (P<0.001). EATV and PATV in persistent AF group were slightly higher than those in paroxysmal AF group, but there was no significant difference between the two groups (P>0.05). There was a significant positive correlation between EATV and PATV in AF group (r=0.961, P<0.001). Logistic regression analysis indicated that EATV was independently associated with AF (OR = 1.091, 95% CI: 1.026–1.158, P = 0.004). The AUC of EATV to predict AF was 0.823 (P<0.001), When the cutoff value of EATV was 97.27 mL, the sensitivity and specificity of the diagnosis of AF were 93.9% and 61.5% respectively. Conclusion 256-slice spiral CCTA allows objective and quantitative measurement of EATV. Increased EATV is closely associated with prevalent AF. However, no significant difference in EATV was observed between different AF subtypes. EATV is an important imaging marker associated with prevalent AF in this retrospective observational case-control study.