Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index

Background: This research focuses on the unresolved question of how low muscle mass influences the likelihood of atrial fibrillation (AF) recurrence after ablation treatment. Despite the growing body of evidence highlighting the importance of muscle mass in cardiovascular health,...

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Main Authors: Pingchuan Ma, Zhicheng Gao, Jiaqi Bao, Yilan Hu, Pengfei Sun, Qiqi Yan, Lifang Ye, Lihong Wang
Format: Article
Language:English
Published: IMR Press 2025-04-01
Series:Reviews in Cardiovascular Medicine
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Online Access:https://www.imrpress.com/journal/RCM/26/4/10.31083/RCM26933
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author Pingchuan Ma
Zhicheng Gao
Jiaqi Bao
Yilan Hu
Pengfei Sun
Qiqi Yan
Lifang Ye
Lihong Wang
author_facet Pingchuan Ma
Zhicheng Gao
Jiaqi Bao
Yilan Hu
Pengfei Sun
Qiqi Yan
Lifang Ye
Lihong Wang
author_sort Pingchuan Ma
collection DOAJ
description Background: This research focuses on the unresolved question of how low muscle mass influences the likelihood of atrial fibrillation (AF) recurrence after ablation treatment. Despite the growing body of evidence highlighting the importance of muscle mass in cardiovascular health, the specific impact of low muscle mass on the recurrence of AF following ablation has yet to be well-established. Thus, this study evaluated the relationship between a low computed tomography (CT)-based skeletal muscle index (SMI) of muscle sites at the fourth thoracic level (T4-SMI) and AF recurrence post-radiofrequency ablation. Furthermore, this study aimed to determine whether the T4-SMI is a predictive marker for AF recurrence. Methods: This study included 641 patients with AF who underwent radiofrequency ablation. T4 muscle sites were determined using SliceOmatic software. Height- and body mass index (BMI)-corrected SMIs were calculated. Results: The lowest quartile in the T4-SMI group was defined for each sex as the “low SMI” group. The height-adjusted T4-SMI thresholds were 69.7 cm2/m2 for males and 55.91 cm2/m2 for females. The BMI-adjusted thresholds were 8.10 cm2/kg/m2 for males and 5.78 cm2/kg/m2 for females. After potential confounder adjustment, low T4-SMI was associated with a higher risk of AF recurrence. The correlation between T4-SMI (height) and AF recurrence was fully validated by constructing multiple models, and adjusting for different covariates barely altered the results. Fully adjusted models suggested that compared with the fourth T4-SMI (height) quartile, the risk odds ratio (OR) with a 95% confidence interval (CI) of the “low SMI” group was 1.57 (0.76–3.22). Finally, subgroup analysis and interaction according to gender, age, overweight/obesity, hypertension, or diabetes indicate that the differences between different layers are not significant. Conclusions: Low CT-based BMI- or height-adjusted T4-SMIs were risk factors for AF recurrence post-radiofrequency ablation. A lower T4-SMI (height) significantly correlated with AF recurrence post-ablation, regardless of gender, age, or overweight/obesity. The height adjustment performed better than the BMI adjustment in that regard.
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spelling doaj-art-ec753e7a69e746ed9ccff5ba4f1245262025-08-20T01:48:21ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-04-012642693310.31083/RCM26933S1530-6550(24)01714-9Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle IndexPingchuan Ma0Zhicheng Gao1Jiaqi Bao2Yilan Hu3Pengfei Sun4Qiqi Yan5Lifang Ye6Lihong Wang7The Second Clinical Medical College, Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, ChinaHeart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), 310000 Hangzhou, Zhejiang, ChinaHeart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), 310000 Hangzhou, Zhejiang, ChinaHeart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), 310000 Hangzhou, Zhejiang, ChinaBackground: This research focuses on the unresolved question of how low muscle mass influences the likelihood of atrial fibrillation (AF) recurrence after ablation treatment. Despite the growing body of evidence highlighting the importance of muscle mass in cardiovascular health, the specific impact of low muscle mass on the recurrence of AF following ablation has yet to be well-established. Thus, this study evaluated the relationship between a low computed tomography (CT)-based skeletal muscle index (SMI) of muscle sites at the fourth thoracic level (T4-SMI) and AF recurrence post-radiofrequency ablation. Furthermore, this study aimed to determine whether the T4-SMI is a predictive marker for AF recurrence. Methods: This study included 641 patients with AF who underwent radiofrequency ablation. T4 muscle sites were determined using SliceOmatic software. Height- and body mass index (BMI)-corrected SMIs were calculated. Results: The lowest quartile in the T4-SMI group was defined for each sex as the “low SMI” group. The height-adjusted T4-SMI thresholds were 69.7 cm2/m2 for males and 55.91 cm2/m2 for females. The BMI-adjusted thresholds were 8.10 cm2/kg/m2 for males and 5.78 cm2/kg/m2 for females. After potential confounder adjustment, low T4-SMI was associated with a higher risk of AF recurrence. The correlation between T4-SMI (height) and AF recurrence was fully validated by constructing multiple models, and adjusting for different covariates barely altered the results. Fully adjusted models suggested that compared with the fourth T4-SMI (height) quartile, the risk odds ratio (OR) with a 95% confidence interval (CI) of the “low SMI” group was 1.57 (0.76–3.22). Finally, subgroup analysis and interaction according to gender, age, overweight/obesity, hypertension, or diabetes indicate that the differences between different layers are not significant. Conclusions: Low CT-based BMI- or height-adjusted T4-SMIs were risk factors for AF recurrence post-radiofrequency ablation. A lower T4-SMI (height) significantly correlated with AF recurrence post-ablation, regardless of gender, age, or overweight/obesity. The height adjustment performed better than the BMI adjustment in that regard.https://www.imrpress.com/journal/RCM/26/4/10.31083/RCM26933atrial fibrillationskeletal muscle indexrecurrencecomputed tomographysarcopenia
spellingShingle Pingchuan Ma
Zhicheng Gao
Jiaqi Bao
Yilan Hu
Pengfei Sun
Qiqi Yan
Lifang Ye
Lihong Wang
Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index
Reviews in Cardiovascular Medicine
atrial fibrillation
skeletal muscle index
recurrence
computed tomography
sarcopenia
title Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index
title_full Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index
title_fullStr Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index
title_full_unstemmed Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index
title_short Evaluation of a Computed Tomography-based Technique for Predicting Atrial Fibrillation Recurrence Following Ablation Using an Adjusted Skeletal Muscle Index
title_sort evaluation of a computed tomography based technique for predicting atrial fibrillation recurrence following ablation using an adjusted skeletal muscle index
topic atrial fibrillation
skeletal muscle index
recurrence
computed tomography
sarcopenia
url https://www.imrpress.com/journal/RCM/26/4/10.31083/RCM26933
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