Search Results for: Linee Guida per le cure post-parto

Circulation, Volume 150, Issue Suppl_1, Page A4139440-A4139440, November 12, 2024. Background:VICTORION-INITIATE (NCT04929249) showed significantly greater LDL-C lowering in patients (pts) with ASCVD with an inclisiran first (IF) strategy (adding inclisiran immediately on failure to achieve LDL-C

Circulation, Volume 150, Issue Suppl_1, Page A4140255-A4140255, November 12, 2024. Pulmonary embolism (PE) is the third leading cause of cardiovascular death. It has been shown to be accompanied by significant psychological distress. The prevalence and longitudinal trends of anxiety and depression in PE patients largely remains unknown. We conducted a prospective observational study examining 188 PE patients attending a dedicated Pulmonary Embolism Response Team (PERT) Clinic. Participants completed standardized assessments using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) to measure anxiety and depression, respectively, following their PE diagnosis and ensuing treatment. Our findings revealed noteworthy gender disparities in the psychological impact of PE on survivors. Among women, 41% reported anxiety and 44% reported depression. Among men, 17% reported anxiety and 20% reported depression. Women more likely to experience depression post-PE and were twice as likely than men to experience anxiety. Furthermore, regardless of gender, we observed a decrease in the prevalence of anxiety and depression over time from the date of initial diagnosis. Younger patients exhibited higher levels of anxiety and depression compared to older counterparts. Additionally, patients with recurrent PE had higher levels of anxiety and depression compared to those with a single thrombotic episode. This study represents the largest dedicated prospective study to date to examine the psychological impact of PE on patients’ psyche. It underscores the significant psychological toll of PE on patients’ recovery. We noted women experienced higher rates of anxiety and depression compared to men. Younger patients and those were recurrent PE were more likely to experience psychological distress. Regardless of age and sex, the prevalence of anxiety and depression decreased with time. These findings highlight the importance of tailored psychosocial support strategies to address the unique emotional needs of patients following a PE diagnosis. Disparities in anxiety and depression prevalence following PE diagnosis and treatment exist. This study highlights the importance of implementing tailored psychosocial support strategies to address the unique emotional needs of PE patients, particularly among women, younger patients, and those with recurrent PE.

Circulation, Volume 150, Issue Suppl_1, Page A4113336-A4113336, November 12, 2024. HeartMate 3 (HM3) is a fully magnetically levitated continuous flow left ventricular assist device (LVAD). In patients with HM3 and recurrent ventricular tachycardia (VT), data on the outcomes of catheter ablation (CA) are insufficient. We report our institutional experience with CA of VT in patients with the HM3.Consecutive patients with HM3 and recurrent drug-refractory VT undergoing CA were included. Ablation sites were identified using activation/entrainment mapping (stable VTs) and/or late/fractionated potential ablation and pace-mapping (unstable VTs). Between 2016-2023 a total of 431 patients (age 58±13, INTERMACS 3±0.98, 44% ischemic cardiomyopathy) received an HM3 LVAD at our institution. Of these, 15 (3.4%) underwent CA for recurrent VT despite therapy with 1.3±0.8 antiarrhythmic drugs a median of 700 days from the LVAD surgery (2 patients

Circulation, Volume 150, Issue Suppl_1, Page A4143303-A4143303, November 12, 2024. Introduction:Preeclampsia is a hypertensive disorder of pregnancy associated with cardiovascular disease. Systemic peripartum microvascular alternations have been implicated in pregnancies complicated by preeclampsia. Whether coronary microvascular dysfunction is a potential mediator of preeclampsia-associated cardiovascular risk is unknown. We aimed to determine whether individuals with a history of preeclampsia have coronary microvascular dysfunction measured by cardiac magnetic resonance imaging (CMR) at least 5 years postpartum.Methods:Women with singleton pregnancies complicated by preeclampsia and a comparator group with uncomplicated, normotensive deliveries were identified and prospectively enrolled to undergo regadenoson stress perfusion CMR (1.5T Signa Artist GE HealthCare) at least 5 years postpartum. Using the dual sequence technique, fully quantitative perfusion values were determined using Fermi deconvolution. Myocardial perfusion reserve (MPR) was calculated as the ratio of stress to rest myocardial blood flow (MBF).Results:Twenty-three subjects (41.0 ± 6 years, 12.7 ± 5 years post-partum) were included. Women with a history of preeclampsia (n=11) were compared to a control group of women with prior normotensive pregnancy (n=12) (Figure 1A). Obesity and diabetes were more common with preeclampsia, but there was no significant difference in the presence of hypertension between the groups (Table 1A). There was no difference in stress MBF. However, preeclampsia was associated with higher rest MBF (1.47 ± 0.54 mL/g/min vs. 1.19 ± 0.29 mL/g/min; p=0.07) and MPR (1.96 ± 0.46 vs 2.66 ± 1.0; p=0.02) compared to normotensive pregnancy (Figure 1). Similarly, corrected MPR remained significantly lower with prior preeclampsia versus uncomplicated pregnancy (2.36 ± 1.0 vs 3.36 ± 1.46; p=0.03).Conclusions:In this study, we observed significantly reduced coronary microvascular function following a pregnancy complicated by preeclampsia at least 5 years postpartum. Heightened cardiovascular risk factors may attenuate this association; however, these observations indicate that systemic microvascular dysfunction in preeclampsia also involves the coronary microcirculation. Further research is needed to better understand the timing and association of these microvascular changes concerning preeclampsia and later heart disease.

Circulation, Volume 150, Issue Suppl_1, Page A4138847-A4138847, November 12, 2024. Background:Zilebesiran is an investigational subcutaneous (SC) RNA interference therapeutic targeting hepatic angiotensinogen synthesis. In the Phase 2 KARDIA-1 study (NCT04936035), changes in blood pressure (BP) were assessed with different zilebesiran dosing regimens as monotherapy in patients with mild-to-moderate hypertension, and clinically significant reductions in ambulatory and office systolic BP (SBP) were observed throughout the 6-month treatment period. In this analysis, we report time-adjusted changes in SBP, a measure of weighted average BP over time, assessed by three modalities: ambulatory, office, and weekly home BP monitoring.Method:Adults with daytime mean ambulatory SBP of 135–160 mmHg were randomized equally to zilebesiran (150 mg, 300 mg, or 600 mg once every 6 months, or 300 mg once every 3 months [Q3M]) or placebo SC Q3M. Secondary and post hoc analyses included calculation of time-adjusted change in SBP from baseline through Month 3 and through Month 6 for ambulatory (24-hour mean and daytime), office, and home BP assessments. Rescue antihypertensive medication was permitted between Months 3 and 5.Results:KARDIA-1 included 377 patients (24.7% Black, 55.7% men, mean age 56.8 years). Time-adjusted least squares mean changes in SBP (mmHg) from baseline through Month 3 for different zilebesiran doses ranged from −5.5 to –9.0 for 24-hour mean ambulatory, −5.7 to –9.2 for daytime mean ambulatory, −9.1 to −10.9 for office, and −8.3 to −9.9 for home BP assessments, compared to −0.6 to 5.6 for placebo across the different modalities (Table). Time-adjusted reductions from baseline in SBP were sustained up to Month 6. Additional measures of BP control through Month 6, including percentage of time in target range, will be presented.Conclusion:Clinically significant time-adjusted reductions observed with self-assessed home BP following treatment with zilebesiran were consistent with ambulatory and office BP reductions, indicating that self-monitoring of BP control with zilebesiran is viable outside of the clinical visit setting. Weekly home BP measurements demonstrated consistent reductions in SBP, highlighting the potential of zilebesiran for providing sustained BP control.

Circulation, Volume 150, Issue Suppl_1, Page A4141328-A4141328, November 12, 2024. Introduction:Diagnosis of exercise-induced pulmonary hypertension (EIPH) or exercise-induced heart failure with preserved left ventricular ejection fraction (E-HFpEF) is challenging due to a lack of consensus. The 2022 ESC/ERS guidelines define EIPH as mean (m) PAP/CO > 3 mmHg/L/min, and E-HFpEF as PCWP/CO > 2 mmHg/L/min, a revision of the previous criteria of mPAP ≥ 30 mmHg and PCWP ≥ 25 mmHg.Hypothesis:We investigated the role of exercise RHC in identifying EIPH and E-HFpEF in a group of patients with dyspnea and correlated the rest echo findings with the E-RHC results. We hypothesized that the resting echo parameters can help identify patients with EIPH and E-HFpEF using 2022 ESC/ERS definitions.Methods:A cohort of patients with dyspnea and normal LVEF with E-RHC data from 2016-2019 was included. Patients were categorized into Groups (g) A-E (Fig 1-T1) according to the 2018 WSPH definition of PH. Echo, hemodynamic, and clinical data were collected. The ESC/ERS 2022 guidelines were used to identify EIPH and E-HFpEF. Echo parameters were retrospectively analyzed by logistic regression analysis.Results:200 patients were included. The mPAP and PCWP, but not PVR, significantly increased post-exercise in all groups. Over 50% of patients in each group had evidence of at least grade I LV diastolic dysfunction on rest Echo (Fig 1). PVs/PVd was significantly lower (0.8±0.3) and E/e’ higher (15±7.9) in g-C (Post-Cap) compared to g-A (No-PH), B (Pre-Cap) and E (undifferentiated). In g-A and g-E, 46.8% and 73% demonstrated EIPH, with 87% and 100% showing a mPAP≥30 mmHg respectively. The prevalence of E-HFpEF in g-A, g-B, and g-E was 45%, 50%, and 63% respectively. Only 34%, 42%, and 56% of subjects in g-A, g-B and g-E demonstrated E-PCWP ≥ 25 mmHg. Echo parameters that predicted E-HFpEF included E and E/e’; E/e’ also predicted EIPH (Fig 1).Conclusions:In this study, Echo features of advanced LV diastolic dysfunction including decreased PVs/PVd and increased E/e’ were associated with post-capillary PH. Rest E/e’ and E (LV rapid inflow velocity) may predict E-HFpEF. Exercise RHC may have utility in the evaluation of patients with suspected subclinical PH and HFpEF, but larger prospective designs are warranted

Circulation, Volume 150, Issue Suppl_1, Page A4145066-A4145066, November 12, 2024. Background:it is unclear if patients implanted with an implantable cardioverter defibrillator (ICD) after an out-of-hospital cardiac arrest (OHCA) have a higher risk of appropriate device therapy than patients implanted for primary and other secondary prevention.Aims:to assess if appropriate device interventions (ATP/shocks) are higher in patients implanted after OHCA compared to patients implanted for primary and secondary prevention other than OHCA. To verify also if mortality, implantation-related complications (pneumothorax, hemothorax, hematoma, cardiac tamponade), device-related complications (lead displacement and fracture, infections) and inappropriate shocks/ATP are higher in OHCA patients.Methods:a retrospective multicenter international study. We included all the patients implanted with an ICD in 2015 and 2016 in the centers. Follow-up was concluded if death or at the last follow-up available until 12/2023. Patients were divided according to ICD indication (secondary prevention after OHCA, other secondary prevention, primary prevention).Results:1386 patients (79% males; median age 67, IQR 59-74) from 15 centers were included (median follow-up 83 months): 111 patients in OHCA group, 134 in other secondary prevention group and 1141 in primary prevention group. Considering the first appropriate intervention, a significant difference among the three groups was observed (Fig.1A) and, at post-hoc comparison, the OHCA group was at higher risk than primary prevention (HR 1.51, 95%CI 1.06-2.17, p=0.02), but was at similar risk than other secondary prevention (HR 0.79, 95%CI 0.51-1.23, p=0.3). This was confirmed also after correction for age, gender, history of atrial fibrillation, aetiology and multi-comorbidity (Fig.2A). Considering the number of appropriate interventions during follow-up, the risk of OHCA group was lower than other secondary prevention (IRR 0.28, 95%CI 0.11-0.68, p

Circulation, Volume 150, Issue Suppl_1, Page A4145774-A4145774, November 12, 2024. Introduction:Little is known about the outcomes of cancer survivors versus patients without a history of cancer undergoing Transcatheter Edge-to-Edge Mitral Valve Repair (TEER) for mitral regurgitation (MR). Moreover, recent publications retrieved conflicting results on the safety and efficacy of TEER in cancer survivors.Hypothesis:Performing TEER in cancer survivors produces similar outcomes when compared to patients with no history of cancer.Aims:Conduct a systematic review and meta-analysis to evaluate clinical outcomes after TEER for MR in patients with versus without a history of cancer.Methods:From inception to December 2023, we systematically searched PubMed, Web of Science, and Embase for studies comparing the safety and efficacy of TEER for MR in cancer survivors versus in patients without a history of cancer. Outcomes of interest were 30-day and 1-year all-cause mortality, incidence of post-procedural MR grade ≥ 3, post-procedural stroke, and 30-day readmissions. Statistical analyses were performed using R software version 4.3.2. We pooled odds ratios (OR) with 95% confidence intervals (CI) for binary endpoints.Results:We included six observational studies comprising 25,334 patients, of whom 6.1% were cancer survivors. Cancer survivors and controls had comparable rates of 30-day all-cause mortality (OR 1.15; 95% CI 0.55 to 2.39; p=0.71), 1-year all-cause mortality (OR 1.61; 95% CI 0.93 to 2.79; p=0.09), post-procedure severe MR (OR 1.49; 95% CI 0.67 to 3.30; p=0.33), post-procedural stroke (OR 1.25; 95% CI 0.47 to 3.27; p=0.66), and 30-day readmission (OR 1.16; 95% CI 0.92 to 1.46; p=0.19).Conclusion:This meta-analysis suggests that cancer survivors with symptomatic MR have similar outcomes after TEER as compared with patients who do not have a history of cancer. Future multicenter studies are warranted to confirm and expand these findings in larger populations and with multivariable-adjusted analysis.

Circulation, Volume 150, Issue Suppl_1, Page A4141714-A4141714, November 12, 2024. Background:Myocardial infarction is a leading cause of morbidity and mortality worldwide, often resulting in extensive myocardial cell death and the release of damage-associated molecular patterns. These DAMPs activate the Stimulator of Interferon Genes pathway, which subsequently induces the release of type I interferon and other pro-inflammatory cytokines, contributing to the inflammatory microenvironment and exacerbating cardiac dysfunction. Curcumol, a compound isolated from the traditional Chinese medicine zedoary turmeric, has demonstrated anti-inflammatory and anti-tumor properties. This study investigates the potential of Curcumol as a novel STING inhibitor to suppress type I interferon release and improve outcomes following MI.Methods:A mouse model of myocardial infarction was established by ligating the left anterior descending coronary artery in vivo. Mice were treated with curcumin, and cardiac function was assessed by echocardiography. Post-myocardial infarction, macrophages were isolated and subjected to RNA-Seq analysis, which revealed that IFNβ1 was the most significantly downregulated transcription factor. Surface plasmon resonance assays were conducted to detect the direct binding of curcumol to the STING protein and validated in vivo using STING knockout mice. In vitro experiments were performed to assess the effect of curcumol on STING oligomerization and transport, utilizing co-immunoprecipitation and immunofluorescence staining.Result:Curcumol treatment improved cardiac function in post-infarction mice, as evidenced by increased ejection fraction and reduced infarct size. In vitro, curcumol significantly reduced the release of type I interferons and the production of pro-inflammatory cytokines. Mechanistically, curcumol inhibited STING ER-to-Golgi translocation by suppressing STING oligomerization, thereby inhibiting STING-dependent pathway activation. Compared to H-151, curcumol demonstrated favorable inhibitory effects and may be a potential novel STING inhibitor.Conclusion:Our study demonstrates that Curcumol, a compound isolated from the traditional Chinese medicine zedoary turmeric, shows significant potential as a novel STING inhibitor. These findings suggest that Curcumol is a promising STING inhibitor for improving outcomes following myocardial infarction by targeting and modulating the STING pathway.Keywords: Curcumol, STING, Type I Interferon, Inflammation, myocardial infarction

Circulation, Volume 150, Issue Suppl_1, Page A4121198-A4121198, November 12, 2024. Background:Cardiopulmonary bypass (CPB) can trigger inflammatory and oxidative stresses in the developing brain. Clinical studies showed altered brain network structure in children after infant cardiac surgery. However, the impact of CPB on structural connectivity remains poorly understood. This study aims to determine the effects of CPB on structural connectivity and underlying cellular events using a juvenile porcine model.Methods:CPB (150 min total) was performed on 2-week-old Yorkshire piglets. High-resolution diffusion tensor imaging (DTI) and neurite orientation dispersion and density (NODDI) imaging were performed 4 weeks post-CPB in a total of 12 animals (Control; n=7, CPB; n=5). Structural connectivity assay together with histological analysis was conducted to assess the brain network organization.Results:Our network analysis (Image 1) revealed a CPB-induced reduction of structural connections in particular nodes, such as in the anterior prefrontal cortex (APC), primary somatosensory cortex, substantia nigra (SN), and globus pallidus (GP). In contrast, there was an increase in the premotor cortex (PreMC), primary motor cortex (PriMC), dorsal posterior cingulate cortex (DPCC), and somatosensory cortex (SAC). Three-dimensional images were generated based on these altered nodes, and tractography was generated to indicate changed fiber tracking (Image 2). We found reduced network connections between the basal ganglia and frontal cortex, and increased connections between the motor and posterior region. DTI and NODDI indicated that microstructures of the superior corona radiata (SCR), internal capsule (PLIC), and anterior prefrontal (AP-WM), motor (PreM-/PriM-WM), and somatosensory white matter (SA-WM) were significantly altered after CPB (Image 3). While Iba1+ microglia was activated across all brain regions after CPB (P

Circulation, Volume 150, Issue Suppl_1, Page A4142395-A4142395, November 12, 2024. Background:Hybrid cardiac rehabilitation (HCR) is an emerging approach to increase participation in cardiac rehabilitation, which targets improvements in functional status and broader risk factor modification including lipid management. However, long-term lipid control trends of patients engaging in HCR remain unexplored.Methods:Using data from a quality improvement program initiated during COVID-19, we conducted a retrospective analysis of 68 adults eligible for HCR from Jan 2021 to Feb 2023 at the Johns Hopkins Health System (Baltimore, MD), utilizing the Corrie digital health platform. This multi-component platform combines expert knowledge with gamified education and virtual coaching to deliver HCR. Patients hospitalized for cardiovascular events qualifying for HCR were recruited for a pilot study of a randomized controlled trial (mTECH REHAB; NCT05238103). We modeled trends in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and triglycerides via mixed-effects regression.Results:Among 68 eligible adults, 41 participated in HCR, with a mean age of 60.1 years, 78.1% male, 24.3% Black, and 14.6% Asian/Mixed. HCR participation was significantly associated with being married (61% vs 33%, p=0.044) or employed (63% vs 26%, p=0.015). On average, 2.3 lipid panels were assessed per person over a median of 12 months (max 30 months) post-discharge. During this period, LDL-C levels decreased from 84.6 mg/dL (95% CI: 75.0-94.1) to 53.0 mg/dL (95% CI: 34.3-71.8) (p for trend = 0.003). Non-HDL-C decreased from 105.9 mg/dL (95% CI: 95.7-116.1) to 74.2 mg/dL (95% CI: 54.1-94.3) (p for trend = 0.005). Levels of HDL-C and triglycerides showed no significant changes (p for trend = 0.724 and 0.607). Among 34 participants with ≥2 lipid panels, the proportion of LDL-C

Circulation, Volume 150, Issue Suppl_1, Page A4147746-A4147746, November 12, 2024. Background:Tachyarrhythmias are a complication of congenital heart disease (CHD) surgery associated with significant morbidity and mortality. Risk scores to predict supraventricular tachycardia (SVT) and accelerated junctional rhythm/junctional ectopic tachycardia (AJR/JET) were previously published, but their performance not evaluated.Objective:To validate risk prediction scores for post-operative SVT and AJR/JET in an external cohort.Methods:Prospective cohort of children 0-18 years undergoing surgery for CHD from 2020-2023. In-hospital telemetry and 12-lead ECGs were reviewed daily for the presence of arrhythmia. C-statistic and Hosmer-Lemeshow tests were used to quantify discrimination and calibration of the model.Results:From 1190 surgeries in 1109 patients (54% male, age 1.71 [IQR 0.3, 6.5] years), SVT occurred in 124 (10%) and AJR/JET in 68 (6%). The observed risk of arrhythmia was significantly higher in the prospective validation cohort than the retrospective cohort. Patients in the prospective cohort were older, more likely to have heterotaxy syndrome and with longer and more complex surgeries than the retrospective cohorts. The model accurately predicted the risk of SVT with a C-statistics of 0.76 [95% CI 0.72, 0.80] and AJR/JET with a C-statistics of 0.63 [95% CI 0.55, 0.70] for AJR/JET. However, the model was not well calibrated with Hosmer-Lemeshow p-value

Circulation, Volume 150, Issue Suppl_1, Page A4142138-A4142138, November 12, 2024. Introduction:Prediabetes is a prominent risk factor for cardiovascular disease (CVD) and type 2 diabetes (T2D). The clinical phenotype of individuals with prediabetes, however, is diverse, and characterization of subphenotypes may identify differing underlying physiology and outcomes. This study aimed to examine associations among prediabetes clusters and time to T2D development.Methods:We performed k-means cluster analyses in a subset of individuals with prediabetes (n=994) from the Diabetes Prevention Program (DPP). Clusters were based on 7 clinically measurable variables (age, body mass index (BMI), waist circumference, triglycerides, HDL cholesterol (HDL-C), fasting glucose (FG), and hemoglobin A1c (HbA1c)). Differences in time to T2D between clusters, overall and by treatment arm, were assessed via Kaplan-Meier survival estimates with post-hoc tests adjusted for multiple comparisons via a Bonferroni correction. Cox proportional Hazard models adjusted for treatment, sex, and race and ethnicity were used to determine T2D hazard ratios (HR) by cluster.Results:Five distinct clusters were identified. 1: “older protected” (highest age and HDL-C, lowest BMI and triglycerides); 2: “dyslipidemia” (highest triglycerides, lowest HDL-C); 3: “insulin resistant” (highest FG and HbA1c); 4: “younger protected” (lowest age, FG and HbA1c, lower BMI and waist circumference); and 5: “larger protected (highest BMI and waist circumference, lower triglycerides). Clusters differed significantly in gender and race and ethnicity. Time to diabetes differed between clusters overall and by DPP treatment arm (fig. 1). Post-hoc tests indicated significantly lower time to T2D, both overall and in placebo, in cluster 3 vs. 1, cluster 2 vs. 4, and cluster 3 vs. 5. Time to T2D was also significantly lower in cluster 5 vs. 4 overall and in lifestyle, and in cluster 3 vs. 4 overall and in all treatment arms (corrected p

Circulation, Volume 150, Issue Suppl_1, Page A4146514-A4146514, November 12, 2024. Background:There is a relative lack of comparative effectiveness research on the safety profile of left atrial appendage occlusion devices (LAAO) in patients ≥ over 85 years of age.Hypothesis:We hypothesize that patients who underwent LAAO older than 85 years will have similar odds of mortality and post-procedure complications when compared with younger patients.Aim:We aim to examine the safety of the in-hospital mortality and immediate complications of patients ≥85 years who underwent LAAO compared to those < 85 years.Methods:Patients undergoing LAAO from 2016-2021 were queried from the National Inpatient Sample. Using propensity score matching, patients were matched into two cohorts based on age ( ≥85 years and 85(p=0.04);

Circulation, Volume 150, Issue Suppl_1, Page A4138788-A4138788, November 12, 2024. Background:Although transcatheter aortic valve replacement (TAVR) devices can impair coronary access, there are limited real-world data on rates of percutaneous coronary intervention (PCI) and PCI outcomes in post-TAVR patients.Research Question:How often do patients who undergo TAVR develop coronary events, and do they have different procedural characteristics or rates of adverse events when undergoing PCI compared to patients without a TAVR?Methods:We used CMS claims data for the Medicare fee-for-service population to evaluate the incidence of PCI after TAVR between 2011-2017. Then, using data from the NCDR CathPCI Registry linked with Medicare claims, we compared procedural characteristics and PCI outcomes between patients with a history of TAVR vs. propensity-matched patients who did not have a history of TAVR.Results:Of the 52,780 Medicare fee-for-service patients who underwent TAVR between 2011-2017, the incidence of acute myocardial infarction (AMI) was 10.6% and of PCI was 5.4% at five years. Among those patients, 5.6% had a PCI in the three months preceding their TAVR. After propensity-score matching, the procedural success rates for PCI were similar between patients with vs. without a history of TAVR. However, in the propensity-matched comparison, PCI in post-TAVR patients required greater fluoroscopic time (21.9 vs 17.7 mins, p

Circulation, Volume 150, Issue Suppl_1, Page A4143358-A4143358, November 12, 2024. Background:Body mass index (BMI), a measure of overall obesity, is associated with various cardiovascular conditions including atrial fibrillation (AF). Epicardial adipose tissue (EAT), a visceral type of adipose tissue, distinct from the subcutaneous adipose tissue, promotes AF arrhythmogenesis through proinflammatory properties and proximity to the myocardium. We sought to compare left atrial (LA) EAT volume with BMI, in their relationship to LA structural remodeling (LA volume and fibrosis) and AF recurrence following catheter ablation.Methods:EAT was assessed via cardiac MRI using the 3D Dixon sequence, and fibrosis was assessed using Late Gadolinium Enhancement (LGE) sequence in 127 AF patients (Panel A). Of this cohort, 101 patients underwent radiofrequency or cryoballoon catheter ablation and were followed for AF recurrence.Results:The mean age of the cohort was 64±11 years (30.7% female). The mean BMI was 29.7±6.6 kg/m2. LA volume index was 57.45±20.58 mL/m2, LA EAT index was 18.1±8.5 mL/m2, and the LA fibrosis was 18.0±7.9%. Compared to BMI, LA EAT index correlated better with LA volume index (LA EAT: R=0.452, p