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Prior studies demonstrated the predictive value of EAT volume (EATV) in atrial fibrillation (AF) among hypertrophic obstructive cardiomyopathy patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the association between EATV and AF in hypertrophic cardiomyopathy (HCM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Two hundred and twenty\u2010four HCM patients (including 79 patients with AF and 145 patients without AF, 154 men) and 80 healthy controls (54 men).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3.0\u2009T scanner; balanced steady\u2010state free precession (SSFP) cine sequence, gradient echo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>EAT thickness was assessed in the 4\u2010chamber and basal short\u2010axis planes. EAT volume was calculated by outlining the epicardial border and visceral pericardium layer on short\u2010axis cine images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Shapiro\u2013Wilk test, Student's <jats:italic>t<\/jats:italic> test or the Mann\u2013Whitney <jats:italic>U<\/jats:italic> test, chi\u2010square test or Fisher's exact test, Multivariate linear regression analyses, Multivariable binary logistic regression analysis. Intraclass correlation coefficient. Significance was determined at <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>EATV and EAT volume index (EATVI) were significantly greater in HCM patients with AF than those without AF (126.6\u2009\u00b1\u200925.9\u2009mL vs. 90.5\u2009\u00b1\u200924.5\u2009mL, and 73.0\u2009\u00b1\u200915.9\u2009mL\/m<jats:sup>2<\/jats:sup> vs. 51.3\u2009\u00b1\u200913.4\u2009mL\/m<jats:sup>2<\/jats:sup>). EATVI was associated with AF in multivariable linear regression analysis among HCM patients (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.62). Multivariable logistic regression analysis revealed that compared to other indicators, the area under curve (AUC) of EATVI was 0.86 (cut\u2010off, 53.9\u2009mL\/m<jats:sup>2<\/jats:sup>, 95% CI, 0.80\u20130.89), provided a better performance, with the sensitivity of 96.2% and specificity of 58.6%. The combined model exhibited superior association with AF presence compared to the clinical model (AUC 0.96 vs. 0.76) and the imaging model (AUC 0.96 vs. 0.93).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>EATVI was associated with AF. EATVI was significantly correlated with incident AF, and provided a better performance in HCM patients compared to other indicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>3<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29525","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T10:53:31Z","timestamp":1720522411000},"page":"1299-1310","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Association of Epicardial Adipose Tissue Volume and Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: As Assessed by Cardiac <scp>MR<\/scp>"],"prefix":"10.1002","volume":"61","author":[{"given":"Chensi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Anhui Medical University, Research Center of 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