Lack of regional association between atrial late gadolinium enhancement on cardiac magnetic resonance and atrial fibrillation rotors
Lack of regional association between atrial late gadolinium enhancement on cardiac magnetic resonance and atrial fibrillation rotors
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DOI：
10.1016/j.hrthm.2015.11.011
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发表时间：
2016-03-01
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：
Chrispin, Jonathan;Ipek, Esra Gucuk;Nazarian, Saman
背景左心房（LA）晚期钆增强（LGE）的程度作为纤维化的替代指标，与导管消融后心房颤动（AF）复发相关。此外，有离体证据表明，纤维化岛可能会锚定颤动转子。 目的 本研究的目的是在心脏磁共振上检查 AF 转子与 LA 和右心房 (RA) LGE 的解剖学关联。 方法 该队列包括 9 名持续性 AF 患者（平均年龄 61.1 +/- 9.7 岁），他们在使用局灶脉冲和转子调制系统进行 AF 消融之前接受了 LGE 心脏磁共振。 LA 和 RA LGE 的范围在全球和 7 个部分中进行了量化：LA 后/下壁、前壁、顶部、左和右肺静脉窦、以及 RA 外侧和间隔区域。使用广义估计方程估计的多变量伯努利逻辑回归来检查转子发生率与整体和每个扇区 LGE 范围的多变量关联。结果 平均 RA 和 LA 体积分别为 113.2 +/- 37.31 和 143.03 +/- 58.25 mL。平均 RA 和 LA LGE 负担分别为 17.2% +/- 11.0% 和 17.4% +/- 14.4%。在所有患者中总共鉴定出 18 个 LA 转子和 9 个 RA 转子。在全局或每个扇区的 LGE 范围与局灶性脉冲和转子调制转子发生率之间没有观察到单变量或多变量关联。 结论 在这组患者中，AF 转子发生率与 RA 和 LA LGE 的全局或区域范围之间没有关联。
BACKGROUND The extent of left atrial (LA) late gadolinium enhancement (LGE), as a surrogate for fibrosis, has been associated with atrial fibrillation (AF) recurrence after catheter ablation. Furthermore, there is ex vivo evidence that islands of fibrosis may anchor fibrillatory rotors.OBJECTIVE The purpose of this study was to examine the anatomical association of AF rotors with LA and right atrial (RA) LGE on cardiac magnetic resonance.METHODS The cohort included 9 patients with persistent AF (mean age 61.1 +/- 9.7 years) who underwent LGE cardiac magnetic resonance before AF ablation using the focal impulse and rotor modulation system. The extent of LA and RA LGE was quantified globally and in each of the 7 sectors: LA posterior/inferior wall, anterior wall, roof, left and right pulmonary vein antra, and RA lateral and septal regions. The multivariable association of rotor incidence with global and per sector LGE extent was examined using multivariable Bernoulli logistic regression estimated by generalized estimating equations.RESULTS The mean RA and LA volumes were 113.2 +/- 37.31 and 143.03 +/- 58.25 mL, respectively. The mean RA and LA LGE burden was 17.2% +/- 11.0% and 17.4% +/- 14.4%, respectively. A total of 18 LA rotors and 9 RA rotors were identified in all patients. No univariable or multivariable association was observed between global or per sector LGE extent and focal impulse and rotor modulation rotor incidence.CONCLUSION In this cohort of patients, there was no association between AF rotor incidence and the global or regional extent of RA and LA LGE.