Why the study?
Resting amygdalar activity is associated with cardiovascular disease, but the underlying mechanisms linking it with persistent atrial fibrillation remain to be comprehensively delineated.
Resting amygdalar activity is significantly associated with persistent atrial fibrillation, an effect that is partially mediated by right atrial inflammatory activity as assessed by 18F-FDG PET/CT.
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Amygdalar activity should not yet guide PerAF care; leaves open neurocardiac inflammatory pathways for prospective validation.
Background: Recent studies have shown that resting amygdalar activity is associated with cardiovascular disease. Nevertheless, the underlying mechanisms that link resting amygdalar activity with persistent atrial fibrillation (PerAF) remain to be comprehensively delineated. We aimed to estimate the association between resting amygdalar activity, right atrium (RA) inflammatory activity, and PerAF. Methods: F-FDG uptake measurements were systematically gathered. Validated methodologies were employed to assess resting amygdalar activity, right atrium target:background ratio (RATBR), and bone-marrow activity (BMA). Associations between resting amygdalar activity and PerAF were assessed via a logistic regression model and mediation (path) analyses. Results: 2.31±0.73) (all P values <0.001). Resting amygdalar activity demonstrated a statistically significant correlation with BMA (r=0.38; P<0.001) and RATBR (r=0.44; P<0.001). BMA significantly mediated the associations between resting amygdalar activity and RATBR, accounting for 50.2% [95% confidence interval (CI): 35.8-76.7%] of this association. Resting amygdalar activity and RATBR emerged as the sole independent variable for PerAF (odds ratio =6.81; 95% CI: 2.34-19.75; P<0.001; odds ratio =9.01; 95% CI: 3.04-26.70; P<0.001). Mediation analysis suggested that RATBR significantly mediated the associations between resting amygdalar activity and PerAF, accounting for 33.2% (95% CI: 16.6-52.4%) of this association. Conclusions: Resting amygdalar activity and RATBR evaluated by PET/CT were significantly associated with PerAF. The association of testing amygdalar activity with PerAF was in part mediated by RA inflammatory activity, which could be a potential therapeutic target for PerAF. Further prospective research is needed to determine the generalizability of these findings.
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Yu et al. (2024) studied this question.
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