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. 2022 Aug 16;38(5):682-693.
doi: 10.1002/joa3.12760. eCollection 2022 Oct.

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

Julia Ilyushenkova  1 , Svetlana Sazonova  1 , Evgeny Popov  1 , Konstantin Zavadovsky  1 , Roman Batalov  1 , Evgeny Archakov  1 , Tatyana Moskovskih  1 , Sergey Popov  1 , Stanislav Minin  2 , Alexander Romanov  2
Affiliations

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

Julia Ilyushenkova et al. J Arrhythm. .

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.

Keywords: CT; atrial fibrillation; epicardial adipose tissue; radiomics.

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Conflict of interest statement

Author J.N. Ilyushenkova declares that she has no conflict of interest; Author S.I. Sazonova declares that she has no conflict of interest; Author E.V. Popov declares that he has no conflict of interest; Author K.V. Zavadovsky declares that he has no conflict of interest; Author R.E. Batalov declares that he has no conflict of interest; Author S.V. Popov declares that he has no conflict of interest; Author E.A. Archakov declares that he has no conflict of interest; Author T.V. Moskovskih declares that she has no conflict of interest; Author S.M. Minin declares that his work was supported by Russian Science Foundation, grant №17‐75‐20118; Author A.B. Romanov declares that his work was supported by Russian Science Foundation, grant №17‐75‐20118.

Figures

FIGURE 1
FIGURE 1
Segmentation of epicardial adipose tissue on noncontrast CT scans: (A) axial slice; (B) frontal slice; (C) sagittal slice.
FIGURE 2
FIGURE 2
Manhattan plots of p‐values for Mann–Whitney U‐test of basic EAT characteristics and all radiomic parameters among Group 1 and Group 2. Negative logarithm of p‐values is plotted on the y‐axis for each of the 93 radiomic parameters lined up on the x‐axis. The green horizontal line p‐value of .05. Parameters above the line are considered statistically significant. EAT, epicardial adipose tissue.
FIGURE 3
FIGURE 3
Manhattan plots of p‐values for Mann–Whitney U‐test of basic EAT characteristics and all radiomic parameters among Group 1a and 1b. Negative logarithm of p‐values are plotted on the y‐axis for each of the 93 radiomic parameters lined up on the x‐axis. The green horizontal line p‐value of .05. Parameters above the line are considered statistically significant. EAT, epicardial adipose tissue.
FIGURE 4
FIGURE 4
Receiver operating curves for gray level nonuniformity GLSZM in predicting late AF recurrence after CA. AF, atrial fibrillation; CA, catheter ablation.
FIGURE 5
FIGURE 5
Kaplan–Meier AF recurrence‐free rate curves (KMunicate‐style plot). AF recurrence‐free curves in patients with gray level nonuniformity GLSZM ≥ 1227.4 and with gray level nonuniformity GLSZM ≤ 1227.4. AF, atrial fibrillation.
See this image and copyright information in PMC

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