The association of pre-existing left atrial fibrosis with clinical variables in patients referred for catheter ablation of atrial fibrillation.
The association of pre-existing left atrial fibrosis with clinical variables in patients referred for catheter ablation of atrial fibrillation.
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DOI：
10.4137/cmc.s15036
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Nazarian S
中科院分区：
文献类型：
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作者：
Dewire J;Khurram IM;Pashakhanloo F;Spragg D;Marine JE;Berger RD;Ashikaga H;Rickard J;Zimmerman SL;Zipunnikov V;Calkins H;Nazarian S
消融术后房颤（AF）复发与晚期钆增强（LGE）磁共振成像（MRI）显示的左心房（LA）纤维化相关。我们试图确定消融前，与接受导管消融术治疗房颤的患者的左心房纤维化程度相关的临床特征。入选接受导管消融术治疗房颤的患者，并在首次房颤消融前接受LGE-MRI。在消融前计算所有患者的纤维化程度占总左心房心肌的百分比。根据纤维化百分比将队列分为四分位数。在入组的60名患者中，13名具有<5%的纤维化（组1），15名具有5-7%的纤维化（组2），17名具有8-13%的纤维化（组3），并且15名具有14-36%的纤维化（组4）。左心房纤维化程度与持续性房颤时间、持续性或长期持续性房颤的存在呈正相关。然而，四组间共病情况、年龄、体重指数、左心房体积或房颤家族史的存在无统计学显著差异。在多变量线性回归模型中调整糖尿病和高血压后，阵发性AF仍然与纤维化程度独立负相关（−4.0 ± 1.8，P = 0.034）。房颤消融患者左心房纤维化程度与房颤类型和持续房颤时间相关。我们的研究结果表明，房颤的存在和持续时间是心房LGE增加的主要决定因素。
Atrial fibrillation (AF) recurrence after ablation is associated with left atrial (LA) fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI). We sought to determine pre-ablation, clinical characteristics that associate with the extent of LA fibrosis in patients undergoing catheter ablation for AF. Consecutive patients presenting for catheter ablation of AF were enrolled and underwent LGE-MRI prior to initial AF ablation. The extent of fibrosis as a percentage of total LA myocardium was calculated in all patients prior to ablation. The cohort was divided into quartiles based on the percentage of fibrosis. Of 60 patients enrolled in the cohort, 13 had <5% fibrosis (Group 1), 15 had 5–7% fibrosis (Group 2), 17 had 8–13% fibrosis (Group 3), and 15 had 14–36% fibrosis (Group 4). The extent of LA fibrosis was positively associated with time in continuous AF, and the presence of persistent or longstanding persistent AF. However, no statistically significant difference was observed in the presence of comorbid conditions, age, BMI, LA volume, or family history of AF among the four groups. After adjusting for diabetes and hypertension in a multivariable linear regression model, paroxysmal AF remained independently and negatively associated with the extent of fibrosis (−4.0 ± 1.8, P = 0.034). The extent of LA fibrosis in patients undergoing AF ablation is associated with AF type and time in continuous AF. Our results suggest that the presence and duration of AF are primary determinants of increased atrial LGE.