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. 2025 Jan 20;25(1):34.
doi: 10.1186/s12872-025-04486-1.

CMR assessment of epicardial edipose tissue in relation to myocardial inflammation and fibrosis in patients with new-onset atrial arrhythmias after STEMI

Yanfei Ren  1 , Xinjia Du  1 , Maochen Li  1 , Lei Chen  2 , Jiahua Liu  1 , Yixuan Wu  1 , Yuan Lu  3
Affiliations

CMR assessment of epicardial edipose tissue in relation to myocardial inflammation and fibrosis in patients with new-onset atrial arrhythmias after STEMI

Yanfei Ren et al. BMC Cardiovasc Disord. .

Abstract

Background: Previous studies have shown that epicardial edipose tissue(EAT) appears to be associated with myocardial inflammation and fibrosis, but this is not clear in patients with new-onset atrial arrhythmias after STEMI. The present study focused on using CMR to assess the association of epicardial fat with myocardial inflammation and fibrosis and its predictive value in patients with new-onset atrial arrhythmias after STEMI.

Methods: This was a single-centre, retrospective study. We consecutively selected patients who completed CMR during their hospitalisation for PCI after STEMI from May 2019-January 2023, and then underwent regular follow-up, grouped by the presence or absence of new atrial arrhythmias, and enrolled patients were divided into atrial arrhythmia and non-atrial arrhythmia groups.

Results: In the atrial arrhythmia group, age, heart rate, Peak hs-TnT, PeakNT-proBNP, EATV, LAES, LAED, T1 native, T1*, ECV, and T2 were higher than those in the non-atrial arrhythmia group, and LVEF was lower than those in the non-atrial arrhythmia group. EATV showed a positive and significant correlation with T1native, T1*, ECV, and T2. (T1 native: r = 0.476,p < 0.001; ECV: r = 0.529,p < 0.001; T1*: r = 0.467,p < 0.001; T2: r = 0.538,p < 0.001). Multifactorial logistic regression analysis showed age, LVEF, EATV, T1*,ECV, T2 as independent risk factors for atrial arrhythmia. (p < 0.05) ROC analysis showed that the AUC for age was 0.568; AUC for LVEF was 0.656; AUC for EATV was 0.768; AUC for ECV was 0.705; AUC for T1* was 0.612; and AUC for T2 was 0.772.

Conclusion: In patients with STEMI, EAT is associated with myocardial inflammation, fibrosis. Age, LVEF, EATV, T1*,ECV, T2 are independent risk factors for new onset atrial arrhythmias and have good predictive value.

Keywords: Atrial arrhythmia; CMR; ECV; Epicardial adipose tissue; T1mapping; T2mapping.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The requirement for signed written consent was waived owing to no risk to the patient in accordance with the relevant IRB regulatory guidelines. This study was approved by the Ethics Committee of Xuzhou Medical University Affiliated Hospital, and complied with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study
Fig. 2
Fig. 2
CMR image analysis. (a-e) A patient with non-atrial arrhythmia: a-epicardial fat image (yellow part); b-T1mapping image; c-ECV image; d-T2mapping image; e-LGE image. EATV = 107 ml; T1 native = 1130ms; T1*=578ms; ECV = 31%;T2 = 56ms. (f-j) A patient with atrial arrhythmia: f-epicardial fat image (yellow part); g-T1mapping image; h-ECV image; i-T2mapping image; j-LGE image. EATV = 156 ml; T1 native = 1425ms; T1*=594ms; ECV = 39%;T2 = 63ms
Fig. 3
Fig. 3
Analysis of differences in CMR parameters between the two groups - violin plot
Fig. 4
Fig. 4
ROC curve analysis
See this image and copyright information in PMC

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