Left ventricular native T1 time and the risk of atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation.
Left ventricular native T1 time and the risk of atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation.
复制标题
DOI：
10.1016/j.ijcard.2015.11.073
复制
发表时间：
2016-01-15
影响因子：
3.5
通讯作者：
Nezafat R
中科院分区：
文献类型：
--
作者：
Kato S;Foppa M;Roujol S;Basha T;Berg S;Kissinger KV;Goddu B;Manning WJ;Nezafat R
天然T1标测已成为评估弥漫性心肌纤维化的无创非造影磁共振成像（MRI）方法。然而，AF患者的LV原生T1时间及其临床相关性尚不清楚。研究了50名接受肺静脉隔离的阵发性房颤患者（60±8岁，37名男性）和11名健康对照受试者（57±8岁，10名男性）。所有患者在MRI扫描期间均处于窦性心律。使用3个短轴平面（基底、中间和顶端切片）中的改良Look-MRI成像（MOLLI）序列，使用心电图触发的单次激发采集（具有平衡稳态自由进动读数），采集天然T1标测图像。获得晚期钆增强（LGE）MRI以评价LV心肌瘢痕。两组之间的LV射血分数相似（AF：61±6%;对照组：60± 6%，p=0.75）。LGE组无左室心肌瘢痕。AF患者的心肌固有T1时间更长（1099±52 vs 1042±20 msec，p<0.001）。在平均326天的随访期内，50例患者中有18例（36%）发生了AF复发。多变量考克斯比例风险分析将自然T1时间升高确定为AF复发的独立预测因素（HR：6.53，95% CI：1.25-34.3，p=0.026）。左室功能保留的房颤患者转介肺静脉隔离（PVI）与正常对照组之间的天然左室心肌T1时间存在差异。自然T1时间是阵发性AF患者肺静脉隔离后AF复发的独立预测因素。
Native T1 mapping has emerged as a noninvasive non-contrast magnetic resonance imaging (MRI) method to assess for diffuse myocardial fibrosis. However, LV native T1 time in AF patients and its clinical relevance are unclear. Fifty paroxysmal AF patients referred for PVI (60±8 years, 37 male) and 11 healthy control subjects (57±8 years, 10 male) were studied. All patients were in sinus rhythm during the MRI scan. Native T1 mapping images were acquired using a Modified Look-Locker imaging (MOLLI) sequence in 3 short-axis planes (basal, mid and apical slices) using an electrocardiogram triggered single-shot acquisition with a balanced steady-state free precession readout. Late gadolinium enhanced (LGE) MRI was acquired to evaluate for LV myocardial scar. LV ejection fraction was similar between groups (AF: 61±6%; controls: 60±6%, p=0.75). No LV myocardial scar was observed in any patient on LGE. Myocardial native T1 time was greater in AF patients (1099±52 vs 1042±20 msec, p<0.001). During a median follow-up period of 326 days, 18 of 50 (36%) patients experienced recurrence of AF. Multivariate Cox proportional hazard analysis identified elevated native T1 time as an independent predictor of recurrence of AF (HR: 6.53, 95% CI: 1.25–34.3, p=0.026). There are differences in the native LV myocardial T1 time between AF patients with preserved LV function referred for PVI and normal controls. Native T1 time is an independent predictor of recurrence of AF after PVI in patients with paroxysmal AF.