Efficacy of epicardial fat combined with left atrial appendage ejection fraction based on multi-slice spiral CT in predicting coronary heart disease patients with atrial fibrillation

  AIM   To investigate the efficacy of detecting epicardial fat (EAT) combined with left atrial appendage ejection fraction (LAAEF) based on multi-slice spiral CT (MSCT) in predicting coronary heart disease patients with atrial fibrillation.

  METHODS   One hundred and eighty-nine patients with coronary heart disease admitted to our hospital from April 2019 to December 2020 were selected and divided into atrial fibrillation group (n=47) and no atrial fibrillation group (n=142) according to whether atrial fibrillation occurred within 6 months. The baseline data, EAT volume and LAAEF of the two groups were compared. Multivariate logistic regression equation was used to analyze the relevant influencing factors of coronary heart disease complicated by atrial fibrillation and receiver operating characteristic curve (ROC) and the area under the ROC (AUC) were used to analyze the EAT volume, the value of LAAEF and their combined use in prediction of atrial fibrillation.

  RESULTS   There were significant differences in hypertension, Gensini scores and coronary heart disease types between the atrial fibrillation group and the non-atrial fibrillation group (P<0.05 or P<0.01). The atrial fibrillation group had higher EAT volume and lower LAAEF than the non-atrial fibrillation group (all P<0.01). After controlling for hypertension, Gensini score and coronary heart disease type, EAT volume and LAAEF were still related factors influencing the occurrence of atrial fibrillation (P<0.01). EAT volume in predicting the AUC of atrial fibrillation was 0.726, LAAEF was 0.777, but EAT volume combined with LAAEF in predicting the AUC of atrial fibrillation was 0.867. The EAT volume of patients with persistent atrial fibrillation was higher than that of patients with paroxysmal atrial fibrillation, and their LAAEF was lower than that of patients with paroxysmal atrial fibrillation (P<0.01).

  CONCLUSION   The use of MSCT to detect coronary heart disease EAT volume and LAAEF predicts the risk of patients with atrial fibrillation, help distinguish different types of atrial fibrillation and provides an objective basis for clinical diagnosis, treatment and intervention.