Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: implications for disease progression and response to catheter ablation.
Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: implications for disease progression and response to catheter ablation.
复制标题
DOI：
10.1016/j.hrthm.2010.06.030
复制
发表时间：
2010-10
期刊：
影响因子：
5.5
通讯作者：
Marrouche, Nassir F.
中科院分区：
文献类型：
--
作者：
Mahnkopf, Christian;Badger, Troy J.;Burgon, Nathan S.;Daccarett, Marcos;Haslam, Thomas S.;Badger, Christopher T.;McGann, Christopher J.;Akoum, Nazem;Kholmovski, Eugene;Macleod, Rob S.;Marrouche, Nassir F.
关键词：
孤立性房颤（AF）被认为是一种良性类型或疾病的早期阶段。本研究旨在比较孤立性房颤患者与合并症患者的延迟增强磁共振成像（DE-MRI）左心房（LA）底物。纳入的333例患者中有40例符合孤立性房颤的标准。所有患者均接受了DE-MRI，以量化心房纤维化作为结构重构（SRM）的标志物，并接受了导管消融术。根据SRM的程度，将患者分为4组：犹他州I（≤5% LA壁增强）、犹他州II（>5%至≤20%）、犹他州III（>20%至≤35%）或犹他州IV（>35%）。犹他州I至IV期孤立性AF和非孤立性AF患者的分布相似。两组中，许多患者显示广泛SRM。两组之间的平均增强（14.08 ± 8.94 vs. 16.94 ± 11.37）无显著差异（P = 0.0721）。在孤立性房颤组中，所有犹他州I、81.82%的犹他州II、62.5%的犹他州III和0例犹他州IV患者的导管消融成功抑制了房颤。在非孤立性AF组中获得了相似的结果。消融术后的结果显著依赖于左心房的SRM（P <0.001）。使用DE-MRI检测到的LA结构重构程度与AF类型和相关合并症无关。使用DE-MRI根据心房纤维化的质量和数量选择适当的治疗候选者将改善手术结果并避免不必要的干预。
Lone atrial fibrillation (AF) is thought to be a benign type or an early stage of the disease. This study sought to compare the left atrium (LA) substrate using delayed-enhanced magnetic resonance imaging (DE-MRI) in patients with lone AF versus those with comorbidities. Forty of 333 included patients met criteria for lone AF. All patients underwent DE-MRI to quantify atrial fibrosis as a marker for structural remodeling (SRM) and underwent catheter ablation. Based on the degree of SRM, patients were staged into 4 groups: Utah I (≤5% LA wall enhancement), Utah II (>5% to ≤20%), Utah III (>20% to ≤35%), or Utah IV (>35%). Distribution in Utah I to IV was comparable in patients with lone AF and non–lone AF. In both groups, a number of patients showed extensive SRM. Mean enhancement (14.08 ± 8.94 vs. 16.94 ± 11.37) was not significantly different between the 2 groups (P = .0721). In the lone AF group, catheter ablation was successful in suppressing AF in all of Utah I, 81.82% of Utah II, 62.5% of Utah III, and none of Utah IV patients. Similar results were achieved in the non–lone AF group. Outcome after ablation was significantly dependent on the SRM of the LA (P < .001). The degree of LA structural remodeling as detected using DE-MRI is independent of AF type and associated comorbidities. Selecting appropriate treatment candidates based on the quality and quantity of atrial fibrosis using DE-MRI would improve procedural outcome and avoid unnecessary intervention.
登录
查看更多内容
影响因子：
2.4
作者：
Lubitz SA;Yi BA;Ellinor PT
通讯作者：
Ellinor PT
影响因子：
30.8
作者：
Ellinor, Patrick T.;Lunetta, Kathryn L.;Glazer, Nicole L.;Pfeufer, Arne;Alonso, Alvaro;Chung, Mina K.;Sinner, Moritz F.;de Bakker, Paul I. W.;Mueller, Martina;Lubitz, Steven A.;Fox, Ervin;Darbar, Dawood;Smith, Nicholas L.;Smith, Jonathan D.;Schnabel, Renate B.;Soliman, Elsayed Z.;Rice, Kenneth M.;Van Wagoner, David R.;Beckmann, Britt-M;van Noord, Charlotte;Wang, Ke;Ehret, Georg B.;Rotter, Jerome I.;Hazen, Stanley L.;Steinbeck, Gerhard;Smith, Albert V.;Launer, Lenore J.;Harris, Tamara B.;Makino, Seiko;Nelis, Mari;Milan, David J.;Perz, Siegfried;Esko, Tonu;Koettgen, Anna;Moebus, Susanne;Newton-Cheh, Christopher;Li, Man;Moehlenkamp, Stefan;Wang, Thomas J.;Kao, W. H. Linda;Vasan, Ramachandran S.;Noethen, Markus M.;MacRae, Calum A.;Stricker, Bruno H. Ch;Hofman, Albert;Uitterlinden, Andre G.;Levy, Daniel;Boerwinkle, Eric;Metspalu, Andres;Topol, Eric J.;Chakravarti, Aravinda;Gudnason, Vilmundur;Psaty, Bruce M.;Roden, Dan M.;Meitinger, Thomas;Wichmann, H-Erich;Witteman, Jacqueline C. M.;Barnard, John;Arking, Dan E.;Benjamin, Emelia J.;Heckbert, Susan R.;Kaeaeb, Stefan
通讯作者：
Kaeaeb, Stefan
影响因子：
3.3
作者：
Corradi, D;Callegari, S;Alfieri, O
通讯作者：
Alfieri, O
影响因子：
5.5
作者：
Murray, KT;Rottman, JN;Ray, WA
通讯作者：
Ray, WA
影响因子：
37.8
作者：
MORILLO, CA;KLEIN, GJ;GUIRAUDON, CM
通讯作者：
GUIRAUDON, CM