The association of left atrial low-voltage regions on electroanatomic mapping with low attenuation regions on cardiac computed tomography perfusion imaging in patients with atrial fibrillation.
The association of left atrial low-voltage regions on electroanatomic mapping with low attenuation regions on cardiac computed tomography perfusion imaging in patients with atrial fibrillation.
复制标题
DOI：
10.1016/j.hrthm.2015.01.015
复制
发表时间：
2015-05
期刊：
影响因子：
5.5
通讯作者：
Nazarian, Saman
中科院分区：
文献类型：
--
作者：
Ling, Zhiyu;McManigle, John;Zipunnikov, Vadim;Pashakhanloo, Farhad;Khurram, Irfan M.;Zimmerman, Stefan L.;Philips, Binu;Marine, Joseph E.;Spragg, David D.;Ashikaga, Hiroshi;Calkins, Hugh;Nazarian, Saman
先前的研究表明，对比增强多排计算机断层扫描（CE-MDCT）可以识别心肌梗死后的心室纤维化。然而，CE-MDCT是否可以表征心房低电压区域仍然未知。本研究的目的是检查CE-MDCT图像衰减与因复发性房颤（AF）接受重复消融术的患者左心房低双极电压区域的相关性。我们招募了20例因房颤复发而接受重复消融术的患者。所有患者均接受了左心房（LA）的术前三维（3-D）CE-MDCT，随后在消融术期间进行了LA的电压标测（>100点）。在多平面CE-MDCT轴向图像上手动绘制左心房心肌周围的心外膜和内膜轮廓。重建左心房心肌的分段三维图像。将电解剖标测图（EAM）点回顾性配准到相应的CE-MDCT图像。在窦性心律下从左心房内膜获得的总共2028个EAM点与分割的左心房壁CE-MDCT图像配准。在线性混合模型中，调整年龄、性别、体重指数和左心房容积以及患者和左心房区域数据聚类后，局部图像衰减比（IAR）每增加一个单位，对数双极电压增加25.2%（P=0.046）。我们证明了来自CE-MDCT的IAR与LA双极电压相关。通过CE-MDCT对纤维化进行成像的潜在能力可能为有MRI禁忌症的患者提供有用的替代方案。
Previous studies have shown that contrast-enhanced multidetector computed tomography (CE-MDCT) could identify ventricular fibrosis following myocardial infarction. However, whether CE-MDCT can characterize atrial low voltage regions remains unknown. The purpose of this study is to examine the association of CE-MDCT image attenuation with left atrial low bipolar voltage regions in patients undergoing repeat ablation for recurrent atrial fibrillation (AF). We enrolled 20 patients undergoing repeat ablation for AF recurrence. All patients underwent pre-procedural three-dimensional (3-D) CE-MDCT of the left atrium (LA) followed by voltage mapping (>100 points) of the LA during the ablation procedure. Epicardial and endocardial contours were manually drawn around LA myocardium on multi-planar CE-MDCT axial images. Segmented 3-D images of the LA myocardium were reconstructed. Electroanatomic map (EAM) points were retrospectively registered to the corresponding CE-MDCT images. A total of 2028 EAM points obtained in sinus rhythm from LA endocardium were registered to the segmented LA wall CE-MDCT images. In a linear mixed model, each unit increase in local image attenuation ratio (IAR) was associated with 25.2% increase in log bipolar voltage (P=0.046) after adjusting for age, gender, body mass index, and LA volume, and clustering of data by patient and LA regions. We demonstrate that IAR derived from CE-MDCT is associated with LA bipolar voltage. The potential ability to image fibrosis via CE-MDCT may provide a useful alternative in patients with contraindications to MRI.
登录
查看更多内容
影响因子：
37.8
作者：
Lardo, AC;Cordeiro, MAS;Lima, JAC
通讯作者：
Lima, JAC
影响因子：
37.8
作者：
Sanders, P;Morton, JB;Kalman, JM
通讯作者：
Kalman, JM
影响因子：
37.8
作者：
Oral, Hakan;Chugh, Aman;Morady, Fred
通讯作者：
Morady, Fred
影响因子：
2.1
作者：
Berliner, Jennifer I.;Kino, Aya;Choudhury, Lubna
通讯作者：
Choudhury, Lubna
影响因子：
3.3
作者：
Spiewak, Mateusz;Malek, Lukasz A.;Ruzyllo, Witold
通讯作者：
Ruzyllo, Witold