Changes in Epicardial Adipose Tissue and Left Atrial Wall Substrate after Ablation for Atrial Fibrillation

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K16071
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Nihon University
• Principal Investigator: WATANABE Ryuta 日本大学, 医学部, 専修医 (70899129)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: カテーテルアブレーション / 心房細動 / 心臓周囲脂肪 / 脂肪浸潤

Outline of Final Research Achievements

To investigate whether sinus rhythm (SR) maintenance after catheter ablation (CA) for atrial fibrillation (AF) provides favorable effects on epicardial adipose tissue (EAT) volume and quality, as well as left atrial (LA) fatty infiltration, multidetector CT was performed within 1 week before and 1 year after ablation. We also evaluated EAT volume, CT attenuation of EAT, and LA wall CT attenuation. A total of 74 AF patients (67±10 years, 54 males) who had undergone CA were included in the study. AF recurrence was observed in 10 patients 1 year after CA. In the non-recurrence group, the EAT volume decreased significantly from before ablation to after CA. Conversely, in the recurrence group, the EAT volume increased significantly from before ablation to after CA. There was no significant difference in the CT attenuation of the whole EAT between the time points before and after CA in both groups. It was suggested that postoperative SR and AF induce temporal changes in EAT.

Free Research Field

医歯薬学

Academic Significance and Societal Importance of the Research Achievements

超高齢社会を迎えた本邦では、脳塞栓症、心不全、認知症の発症や死亡率上昇に寄与する心房細動（AF）が増加し、AFパンデミック時代を迎えている。AFに対するカテーテルアブレーション治療の予後改善効果が認められているが、その効果は不完全である。本研究では、従来検証されていない、AFの原因の一つとされる心臓周囲脂肪（EAT）および心房への脂肪浸潤の経時的変化をCT画像で解析した。本結果より、カテーテルアブレーション術後1年間の洞調律・AFのリズムがEATに影響を与えることを明らかにした。EATを減少させる新たな治療戦略がAF予防につながる可能性がある。