Number of P-wave fragmentations on P-SAECG correlates with infiltrated atrial fat.
Number of P-wave fragmentations on P-SAECG correlates with infiltrated atrial fat.
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DOI：
10.1111/anec.12084
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Tereshchenko LG
中科院分区：
文献类型：
--
作者：
Murthy S;Rizzi P;Mewton N;Strauss DG;Liu CY;Volpe GJ;Marchlinski FE;Spooner P;Berger RD;Kellman P;Lima JA;Tereshchenko LG
虽然心房纤颤（AF）触发因素是已知的，但对潜在的AF基质了解较少。本研究的目的是探讨阵发性房颤患者和房颤风险个体的心房电生理和结构特征之间的相关性。窦性心律患者（N=90，年龄57± 10岁; 55名男性[63.2%]），患有结构性心脏病和阵发性AF（n=12 [13%]），或具有AF风险因素和LVEF > 35%（n=78），接受SAECG和心脏磁共振研究。在水平纵轴上，使用Dark-blood DIR制备的Fat-Water-separated序列分析心房和心外膜脂肪。在窦性心律期间，在SAECG导联上识别所有局部P波极值。P波碎裂（Pf）被定义为相邻极值之间的绝对差，其高于噪声的3个标准差，并通过相应导联中P波的持续时间进行归一化。滤波后的P-SAECG信号的Pf大于未滤波的P-SAECG信号（13.1±3.8 vs. 3.4±1.2; P < 0.0001）。Y电极导线的Pf最大（Y电极导线为13.0±3.5 vs. Z电极导线为12.1±3.4; P=0.003）。Z导联Pf与房间隔脂肪指数相关（r=0.544; P=0.001）。心外膜脂肪与体重指数显著相关（r=0.302; P=0.015）。校正BMI、左心房（LA）大小、心外膜脂肪和房间隔宽度后，房间隔脂肪与Z导联Pf独立相关[β系数0.009（95%CI 0.0003-0.019）; P=0.043]。心房脂肪浸润与左心房后壁不连续传导相关，代表房颤早期基质。
While atrial fibrillation (AF) triggers are known, the underlying AF substrate is less well understood. The goal of our study was to explore correlations between electrophysiological and structural characteristics of atria in patients with paroxysmal AF and individuals at AF risk. Patients in sinus rhythm (N=90, age 57±10y; 55 men [63.2%]) with structural heart disease and paroxysmal AF (n=12 [13%]), or with AF risk factors and LVEF > 35% (n=78), underwent SAECG and cardiac magnetic resonance study. Interatrial and epicardial fat was analyzed with a Dark-blood DIR-prepared Fat-Water-separated sequence in the horizontal longitudinal axis. All local P-wave extrema were identified on SAECG leads during sinus rhythm. A P-wave fragmentation (Pf ) was defined as an absolute difference between adjacent extrema which was above 3 standard deviations of noise, and was normalized by the duration of the P-wave in the corresponding lead. The Pf was greater on the filtered than on the unfiltered P-SAECG signal (13.1±3.8 vs. 3.4±1.2; P < 0.0001). Pf was the greatest on the Y lead (13.0±3.5 on Y lead vs. 12.1±3.4 on Z lead; P=0.003. Pf on Z lead correlated with interatrial fat index (r=0.544; P=0.001). Epicardial fat significantly correlated with body mass index [BMI] (r=0.302; P=0.015). After adjustment for BMI, left atrium (LA) size, epicardial fat and interatrial septum width, interatrial fat independently associated with the Pf on Z lead [β-coefficient 0.009 (95%CI 0.0003–0.019); P=0.043]. Infiltrated atrial fat correlates with discontinuous conduction on posterior LA wall and represents AF early substrate.
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影响因子：
3.3
作者：
Kellman, Peter;Hernando, Diego;Shah, Saurabh;Zuehlsdorff, Sven;Jerecic, Renate;Mancini, Christine;Liang, Zhi-Pei.;Arai, Andrew E.
通讯作者：
Arai, Andrew E.
影响因子：
2.8
作者：
FURBERG, CD;PSATY, BM;RAUTAHARJU, PM
通讯作者：
RAUTAHARJU, PM
影响因子：
37.8
作者：
Mazurek, T;Zhang, LF;Shi, Y
通讯作者：
Shi, Y
影响因子：
1.9
作者：
Holmqvist, Fredrik;Platonov, Pyotr G.;Moss, Arthur J.
通讯作者：
Moss, Arthur J.
影响因子：
2.2
作者：
Lacobellis, G.;Barbaro, G.
通讯作者：
Barbaro, G.