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Incidence of new-onset atrial fibrillation in COVID-19 is associated with increased epicardial adipose tissue
Journal of Interventional Cardiac Electrophysiology ( IF 1.8 ) Pub Date : 2021-07-07 , DOI: 10.1007/s10840-021-01029-4
Leandro Slipczuk 1, 2 , Francesco Castagna 1 , Alison Schonberger 3 , Eitan Novogrodsky 3 , Damini Dey 4 , Ulrich P Jorde 1, 2 , Jeffrey M Levsky 2, 3 , Luigi Di Biase 1, 2 , Mario J Garcia 1, 2, 3
Affiliation  

Purpose

Coronary artery calcium (CAC) and epicardial adipose tissue (EAT) can predict AF in the general population. We aimed to determine if CAC and EAT measured by computed tomographic (CT) scanning can predict new-onset AF in patients admitted with COVID-19 disease.

Methods

We performed a retrospective, post hoc analysis of all patients admitted to Montefiore Medical Center with a confirmed COVID-19 diagnosis from March 1st to June 23rd, 2020, who had a non-contrast CT of the chest within 5 years prior to admission. We determined ordinal CAC scores and quantified the EAT volume and examined their relationship with inpatient mortality.

Results

A total of 379 patients were analyzed. There were 16 events of new-onset AF (4.22%). Patients who developed AF during the index admission were more likely to be male (75 vs 47%, p < 0.001) and had higher EAT (129.5 [76.3–197.3] vs 91.0 [60.0–129.0] ml, p = 0.049). There were no differences on age (68 [56–71] vs 68 [58–76] years; p = 0.712), BMI (28.5 [25.3–30.8] vs 26.9 [23.1–31.8] kg/m2; p = 0.283), ordinal CAC score (3 [1–6] vs 2 [0–4]; p = 0.482), or prevalence of diabetes (56.3 vs 60.1%; p = 0.761), hypertension (75.0 vs 87.3%, p = 0.153), or coronary artery disease (50.0 vs 39.4%, p = 0.396). Patients with new-onset AF had worse clinical outcomes (death/intubation/vasopressors) (87.5 vs 44.1%; p = 0.001).

Conclusion

Increased EAT measured by non-contrast chest CT identifies patients hospitalized with COVID-19 at higher risk of developing new-onset AF. Patients with new-onset AF have worse clinical outcomes.



中文翻译:

COVID-19 中新发心房颤动的发生率与心外膜脂肪组织增加有关

目的

冠状动脉钙 (CAC) 和心外膜脂肪组织 (EAT) 可以预测普通人群的 AF。我们旨在确定通过计算机断层扫描 (CT) 扫描测量的 CAC 和 EAT 是否可以预测 COVID-19 疾病入院患者的新发 AF。

方法

我们对 2020 年 3 月 1 日至 6 月 23 日期间入住 Montefiore 医疗中心且确诊为 COVID-19 的所有患者进行了回顾性事后分析,这些患者在入院前 5 年内进行了胸部非增强 CT。我们确定了有序 CAC 评分并量化了 EAT 体积并检查了它们与住院死亡率的关系。

结果

共分析了 379 名患者。有 16 起新发 AF 事件(4.22%)。在入院时发生 AF 的患者更可能是男性(75 对 47%,p  < 0.001)并且有更高的 EAT(129.5 [76.3–197.3] 对 91.0 [60.0–129.0] ml,p  = 0.049)。年龄(68 [56-71] vs 68 [58-76] 岁;p  = 0.712)、BMI(28.5 [25.3-30.8] vs 26.9 [23.1-31.8] kg/m 2p  = 0.283 )没有差异),CAC 顺序评分(3 [1-6] vs 2 [0-4];p  = 0.482),或糖尿病患病率(56.3 vs 60.1%;p  = 0.761),高血压(75.0 vs 87.3%,p  = 0.153 ),或冠状动脉疾病(50.0 对 39.4%,p = 0.396)。新发房颤患者的临床结局更差(死亡/插管/血管加压药)(87.5% vs 44.1%;p  = 0.001)。

结论

通过非对比胸部 CT 测量的 EAT 增加可识别因 COVID-19 住院的患者发生新发 AF 的风险较高。新发房颤患者的临床结果较差。

更新日期:2021-07-07
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