Right atrial function and fibrosis in relation to successful atrial fibrillation ablation.
Right atrial function and fibrosis in relation to successful atrial fibrillation ablation.
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DOI：
10.1093/ehjci/jeac152
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发表时间：
2023-02-17
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中科院分区：
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心房颤动(AF)患者的双房重构很少被评估，关于右心房(RA)纤维化的存在、RA与左房(LA)纤维化的关系以及AF患者消融后RA重构与房颤复发的可能关联的数据有限。本研究共纳入110例接受肺静脉隔离(PVI)的房颤患者。所有患者在消融前进行心脏磁共振(CMR)成像时均为窦性心律。从电影CMR图像中得出LA和RA的体积和功能(体积和特征跟踪应变)。根据3D晚期Gd增强图像评估LA和RA的纤维化程度。采用12导联心电图或动态心电图对房颤复发进行12个月的随访。39名患者(36%)在90天的消融期后再次发生心律失常，发生时间中位数为181天(四分位数范围：122-286天)。房颤消融后复发和未复发患者的RA重构参数无显著差异，而LA重构参数(容量、排空分数和应变指数)有所不同。LA纤维化与RA纤维化有很强的相关性(r=0.88，P<0.001)。房颤复发和未复发患者的LA和RA纤维化程度无明显差异。这项研究表明，RA重构参数不能预测房颤消融后的复发。房颤患者存在双房纤维性重构，而且LA纤维化量与RA纤维化量有很强的相关性。
Bi-atrial remodelling in patients with atrial fibrillation (AF) is rarely assessed and data on the presence of right atrial (RA) fibrosis, the relationship between RA and left atrial (LA) fibrosis, and possible association of RA remodelling with AF recurrence after ablation in patients with AF is limited. A total of 110 patients with AF undergoing initial pulmonary vein isolation (PVI) were included in the present study. All patients were in sinus rhythm during cardiac magnetic resonance (CMR) imaging performed prior to ablation. LA and RA volumes and function (volumetric and feature tracking strain) were derived from cine CMR images. The extent of LA and RA fibrosis was assessed from 3D late gadolinium enhancement images. AF recurrence was followed up for 12 months after PVI using either 12-lead electrocardiograms or Holter monitoring. Arrhythmia recurrence was observed in 39 patients (36%) after the 90-day blanking period, occurring at a median of 181 (interquartile range: 122–286) days. RA remodelling parameters were not significantly different between patients with and without AF recurrence after ablation, whereas LA remodelling parameters were different (volume, emptying fraction, and strain indices). LA fibrosis had a strong correlation with RA fibrosis (r = 0.88, P < 0.001). Both LA and RA fibrosis were not different between patients with and without AF recurrence. This study shows that RA remodelling parameters were not predictive of AF recurrence after AF ablation. Bi-atrial fibrotic remodelling is present in patients with AF and moreover, the amount of LA fibrosis had a strong correlation with the amount of RA fibrosis.
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DOI：
10.1093/ehjci/jeab245
发表时间：
2022-08-22
期刊：
European heart journal. Cardiovascular Imaging
影响因子：
--
作者：
通讯作者：
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影响因子：
4.6
作者：
Luetkens JA;Wolpers AC;Beiert T;Kuetting D;Dabir D;Homsi R;Meendermann H;Dayé NA;Knappe V;Karsdal M;Nielsen SH;Genovese F;Stöckigt F;Linhart M;Thomas D;Nickenig G;Schild HH;Schrickel JW;Andrié RP
通讯作者：
Andrié RP
影响因子：
6.1
作者：
Maesen, Bart;Verheule, Sander;Zeemering, Stef;La Meir, Mark;Nijs, Jan;Lumeij, Stijn;Lau, Dennis H.;Granier, Mathieu;Crijns, Harry Jgm;Maessen, Jos G.;Dhein, Stefan;Schotten, Ulrich
通讯作者：
Schotten, Ulrich
影响因子：
7.5
作者：
Akutsu, Yasushi;Kaneko, Kyouichi;Kobayashi, Youichi
通讯作者：
Kobayashi, Youichi
影响因子：
6.1
作者：
Eichenlaub, Martin;Mueller-Edenborn, Bjoern;Jadidi, Amir
通讯作者：
Jadidi, Amir