Evgeny Popov

Platonov A. S. ¹ , Kunitsyn S. A. ¹ , Popov S. V. ¹ Aim. To assess the impact of coronary atherosclerosis in patients with atrial fibrillation (AF) on the radiographic density of epicardial adipose tissue (EAT), and to determine its prognostic value. Material and methods. The study included 69 patients (median age 47 (40; 58) years; 48 men) with AF (group 1) scheduled for radiofrequency ablation (RFA). The comparison group (group 2) included 37 patients with non-obstructive coronary artery disease (NOCAD) without arrhythmias, and the control group included 20 patients without coronary atherosclerosis and arrhythmias. All patients underwent computed tomography coronary angiography (CTCA), followed by EAT segmentation and calculation of EAT volume and radiographic density. Patients with AF were followed for 12 months after RFA to assess for arrhythmia recurrence. Results. In patients with AF, the EAT volume was significantly higher (141,0 (113,3; 187,5) cm ³ vs 107,5 (86,9; 126,1) cm ³ , pConclusion. In patients with AF and NOCAD, EAT radiographic density are lower compared to patients with AF without coronary atherosclerosis and the control group. In the studied sample of patients, EAT radiographic density did not demonstrate significance in the prognosis of AF recurrence after RFA of arrhythmia.

Aim. To evaluate the association of computed tomography measurements (volume and density) of epicardial adipose tissue (EAT) with the blood concentration of adipokines, proinflammatory cytokines and catecholamines in patients with atrial fibrillation (AF).Methods. We included 32 patients (median age 58.5 (52.5; 64.0); 18 men) with AF scheduled for radiofrequency ablation. All patients underwent multispiral computed tomographic coronary angiography and segmentation of the EAT. In addition, the concentration of adiponectin, leptin, resistin, interleukins 1b, 6, 8 and methanephrine in the blood was determined by enzyme immunoassay.Results. А negative correlation was established between the volume and the density of EAT (r= - 0.5, pConclusion. The results of the study showed an association between EAT X-ray density and the concentration of leptin, interleukin-8 and metanephrine in AF patients.

Introduction. Multispiral computed tomography (MSCT) coronary angiography (CAG) is a highly informative method of visualizing atherosclerotic plaques in the coronary arteries and assessing their structure. At the same time, this method has a few significant drawbacks associated with the intravenous administration of iodine-containing radiopaque agents as well as high radiation exposure. The radiomic analysis of contrast-free MSCT images allows calculating many additional quantitative parameters, which can potentially be associated with atherosclerotic plaque instability and the degree of coronary artery stenosis. At the same time, the prognostic and diagnostic value of radiomic characteristics has not been investigated.Aim: To assess whether there is an association between radiomic indexes of EAT on non-contrast MSCT cardiac images with the degree of atherosclerotic coronary artery stenosis in patients with stable CAD, as well as the incidence of acute coronary syndrome (ACS) within 5 years in this category of patients.Material and Methods. We retrospectively reviewed 100 MSCT-CAG studies performed to diagnose coronary heart disease in patients. 39 patients with signs of coronary stenosis up to 50% and registered in Tomsk medical information systems (MIS) for at least 5 years were selected, as well as 15 people without signs of coronary arteries (CA) atherosclerosis as a control group. Epicardial adipose tissue (EAT) volume was assessed and 837 radiomic characteristics were calculated on non-contrasted MSCT cardiac images of all patients (54 people). The presence or absence of ACS within 5 years after MSCT-CAG in each patient was monitored according to Tomsk MIS data. Statistical analysis and comparison of indices were performed in control group (group 2) and study group (group 1), as well as in subgroups of patients who had suffered AMI (group 1a) and those who had not (group 1b).Results. When comparing group 1 with the control group, significant differences (p < 0.05) were found for all radiomic parameters, density, and volume of EAT. Correlation analysis did not reveal any relationship between the radiomic characteristics of EAT and the degree of coronary artery stenosis, as well as the calcium index. According to the results of the MIS of Tomsk analysis, group 1 was divided into 2 subgroups: without ACS (group 1a; n = 27 (50%)) and with ACS (group 1b; n = 12 (22%)). When comparing subgroups 1a and 1b, there were no significant differences in the volume and density of EAT (p > 0.05), however, 8 out of 837 radiomic parameters differed significantly. Multiple regression analysis has shown that the Size Zone Nonuniformity gray level zone matrix (SZN-GLSZM) and Gray Level Variance (GLCM) gray co-occurrence matrix are independent predictors of the development of ACS within 5 years. According to the results of the ROC analysis, the logistic model with the inclusion of radiomic data showed high sensitivity and specificity in predicting the development of ACS (cut-off point p < 0.001 for SZN; cut-off point p < 0.001).Conclusion. SZN GLSZM and GLV GLCM radiomic features on non-contrast MSCT images of EAT are associated with the incidence of ASC in patients with coronary artery atherosclerosis. Radiomic analysis of EAT could potentially be used for personalized assessment of the ACS risk.

Background: Epicardial adipose tissue (EAT) has been considered as one of the probable triggers of atrial fibrillation (AF). CT‐rediomics is a perspective noninvasive method of assessment of EAT. We evaluate the radiomic phenotype of EAT in patients with lone AF in the prognosis of AF recurrence after catheter ablation.Methods: A total of 43 patients with lone AF referred for CA and 20 out‐hospital patients without arrhythmia underwent multidetector computed tomography coronary angiography. Segmentation of EAT and extraction radiomic features were performed on calcium scoring series using by 3D‐Slicer. Clinical follow‐up was performed for 12 months period after the CA.Results: EAT in patients with lone AF had a distinct radiomic phenotype. Thus, 45 of 93 calculated radiomic features, volume and attenuation of EAT were significantly different between patients with lone AF and persons without any arrhythmia. In addition, 17 radiomic features were significantly different in subgroups with and without AF recurrence. Multivariate regression analysis demonstrated that only gray level nonuniformity normalized (GLSZM) was an independent predictor of AF recurrence (OR 1.0027, 95%CI 1.0009–1.0044, p = 0.002). ROC analysis data showed that GLSZM >1227.4 indicates high probability of AF recurrence during 12 months (sensitivity 89.4%, specificity 70.8%, AUC: 0.809; p = 0.001).Conclusion: The radiomic parameter GLSZM is associated with late AF recurrence after CA in patients with lone AF. In current study GLSZM was a stronger predictor of lone AF recurrence in multivariate analysis comparing with other established risk factors and EAT volume and attenuation.

The majority of modern biomedical research is aimed at personifying the diagnosis and treatment of various diseases. An individual approach can be implemented using radiomics — the latest radiation diagnostics associated with the extraction of a large number (from hundreds to several thousand) of additional quantitative indicators from medical images using specialized software. The method is actively used in oncology to identify radiochemoresistant tumor zones, as well as non-invasive determination of the phenotype and genotype of the neoplasm. At the same time, the prospects for the application and clinical significance of this approach in cardiology have not yet been determined and have been the subject of active research in recent years. In this regard, the purpose of this review was to collect information from available databases and assess the degree of knowledge of the problem of radiomic analysis of heart images using various radiation modalities, as well as to determine the prospects for using this approach in clinical practice.

Aim. To investigate the association of the radiomic characteristics of epicardial adipose tissue (EAT) on contrast-free computed tomography (CT) of the heart with the severity of obstructive coronary lesion and myocardial ischemia.Methods. The study included 68 patients with coronary heart disease (mean age of 63.5±9.4, 45 men and 23 women), and 15 patients (mean age 30±4.8; 14 men and 1 woman) without cardiovascular disease as a control group. All the patients underwent multispiral computed coronary angiography, coronary calcium scores (CCS) determination and stress myocardial perfusion scintigraphy. Radiomic characteristics of EAT (texture analysis by gradations of gray color) were determined on non-contrast computer tomogram images of the heart using 3D-Sliser software and the SliserRadiomics module (version 4.10.2). The obtained indicators were compared between a control and under the study groups as well as between subgroups of patients divided according to the degree of obstruction of the coronary arteries, the size of the perfusion defect, and the value of the CCS.Results. The comparative analysis of radiomic indicators of EAT between patients with coronary artery disease and the control group showed the presence of statistically significant differences between them. At the same time, the correlation analysis in the study group did not reveal any correlations between the radiomic parameters and the size of the perfusion defect, CCS or degree of stenosis of the lumen of the coronary arteries.Conclusion. The textural characteristics of EAT in patients with coronary heart disease differ from those in individuals without cardiovascular pathology. At the same time, these indicators are not associated with the severity of obstructive lesions of the coronary arteries, the value of the CCS, and the size of the perfusion defect according to scintigraphy.

Aim. To investigate the relationship between radiological characteristics of epicardial adipose tissue (EAT) and myocardial sympathetic activity, as well as to study their association with late recurrence of atrial fibrillation (AF) after radiofrequency ablation (RFA).Material and methods. This prospective study included 26 people with persistent and long-standing persistent AF scheduled for interventional AF treatment. Before the RFA procedure, all patients underwent cardiac 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy to assess the myocardial sympathetic innervation and contrast-enhanced cardiac multislice computed tomography to assess pulmonary vein anatomy, left atrial volume, and EAT volume. Clinical follow-up, including 12-lead electrocardiography (ECG) and 24-hour ECG monitoring, was carried out 3, 6 and 12 months after RFA.Results. After the end of follow-up, the patients were divided into two groups: with AF recurrence (group 1, n=8) and without AF recurrence (group 2, n=18). Multivariate logistic analysis found that only the 123I-MIBG washout rate (odds ratio, 1,0943; 95% confidence interval, 1,0138-1,1812) proved to be an independent predictor of late AF recurrence after RFA. ROC analysis revealed that a 123I-MIBG washout rate >21% with a sensitivity of 75% and a specificity of 83,3% (AUC=0,844; pConclusion. Parameters of myocardial sympathetic activity, assessed by 123I-MIBG myocardial scintigraphy, are associated with late AF recurrence after RFA in patients with persistent and long-standing persistent AF. There were no reliable data confirming associations between myocardial sympathetic innervation and radiological EAT indicators, as well as the effect of the latter on the risk of AF recurrence after RFA.