ArticlePhysiological research2025
Post-Operative Atrial Fibrillation: Novel Predictive Value of CT-Derived Adipose Tissue Density in Minimally Invasive Mitral Surgery.
Article in Physiological research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Postoperative atrial fibrillation (POAF) remains a significant complication following minimally invasive thoracoscopic mitral valve surgery (MITMVS), yet current risk prediction models inadequately capture the underlying metabolic determinants of arrhythmogenesis. We investigated whether computed tomography (CT)-derived body composition parameters, as markers of metabolic status, could predict POAF risk in patients undergoing mitral valve repair. We retrospectively studied 104 consecutive MITMVS patients (2014-2023). Preoperative CT scans quantified skeletal muscle index, muscle density, and visceral/subcutaneous adipose tissue. Patients were grouped by preexisting atrial fibrillation (AF) with concurrent Maze (n=48) vs. no AF history (n=56). The primary outcome was POAF development. Higher visceral (VAT) and subcutaneous (SAT) adipose tissue density showed associations with increased POAF odds in multivariable analysis (VAT: OR 1.075, 95 % CI: 1.010;1.149, p=0.026; SAT: OR 1.073, 95 % CI: 1.011;1.146, p=0.025). Quartile analysis revealed a striking 5.5-fold increased POAF risk in the highest VAT density quartile compared to the lowest (42.3 % vs. 7.7 %). Notably, the relationship between intramuscular adipose tissue (IMAT) density and POAF differed between groups (interaction p=0.029), with a positive association in patients without prior AF (OR 1.167, 95 % CI: 1.011;1.377, p=0.047), but no significant relationship in those with preexisting AF (p=0.175). CT-derived tissue quality parameters, particularly VAT density, demonstrate robust associations with POAF risk following MITMVS. These findings establish preoperative CT-based metabolic assessment as a promising tool for perioperative risk stratification without additional testing burden. Key words Postoperative atrial fibrillation " Body composition " Computed tomography " Mitral valve surgery " Metabolic risk factors.
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41511103PMC12849796What OpenQuestion holds
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