Characteristics of left atrial remodeling in patients with atrial fibrillation and hypertrophic cardiomyopathy in comparison to patients without hypertrophy.
Characteristics of left atrial remodeling in patients with atrial fibrillation and hypertrophic cardiomyopathy in comparison to patients without hypertrophy.
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DOI：
10.1038/s41598-021-91892-y
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发表时间：
2021-06-14
影响因子：
4.6
通讯作者：
Müssigbrodt A
中科院分区：
文献类型：
--
作者：
Nedios S;Dinov B;Seewöster T;Lindemann F;Richter S;Arya A;Dagres N;Husser D;Bollmann A;Hindricks G;Müssigbrodt A
心房颤动 (AF) 会导致左心房 (LA) 大小和形状发生变化的重构。在这里，我们的目的是研究肥厚型心肌病 (HCM) 对 AF 患者 LA 重塑模式的影响。将接受 AF 消融（2009-2012 年）的 HCM 患者 (n = 23) 与我们前瞻性登记中的 125 名非 HCM 患者进行匹配和比较。分析术前 CT 数据（EnSite Verismo、SJM、MN）以确定最大矢状（前后，AP）、冠状（上下，SI 和横向，TV）尺寸和球形指数（LAS）。在排除附件（LAA）和肺静脉（PV）后呈现体积（LAV）。 PV 口/LAA 之间并平行于后壁的切割平面将 LAV 分为前部 (LAA) 和后部 LA (LAP) 部分。 LA-A/LAV 的比率定义为不对称指数（ASI）。与非 HCM 患者相比，HCM 患者的室间隔较宽，左心室较小。 HCM 患者的 LA 体积（LAV 166±±72 vs. 130±±36 ml，p=±0.03）和 LA 直径显着更大。前部容积 (LA-A: 112± 48 vs. 83 ± 26 ml, p < 0.001) 组间差异显着，而后部容积 LA-P (55 ± 28 vs. 47 ± 13 ml, p = 0.23) 和 LAS (75% vs. 78%，p = 0.089）两组相似。结果，HCM 患者的 ASI 显着高于非 HCM 患者（67±±6% vs. 63±±6%，p=±0.01）。总之，AF 和 HCM 患者的 LA 重塑的特点是不对称扩张，由前扩张而非后扩张驱动。这可以通过三维成像来表征，并且可以用作高级心房重塑的替代。
Atrial fibrillation (AF) leads to remodeling characterized by changes in both size and shape of the left atrium (LA). Here we aimed to study the effect of hypertrophic cardiomyopathy (HCM) on the pattern of LA remodeling in AF-patients. HCM-patients (n = 23) undergoing AF ablation (2009–2012) were matched and compared with 125 Non-HCM patients from our prospective registry. Pre-procedural CT data were analyzed (EnSite Verismo, SJM, MN) to determine the maximal sagittal (anterior–posterior, AP), coronal (superior-inferior, SI and transversal, TV) dimensions and the sphericity index (LAS). Volume (LAV) was rendered after appendage (LAA) and pulmonary vein (PV) exclusion. A cutting plane, between PV ostia/LAA and parallel to the posterior wall, divided LAV into anterior- (LAA) and posterior-LA (LAP) parts. The ratio LA-A/LAV was defined as asymmetry index (ASI). HCM patients had a wider inter-ventricular septum and a smaller LV than Non-HCM patients. LA volume (LAV 166 ± 72 vs. 130 ± 36 ml, p = 0.03) and LA diameters were significantly larger in HCM patients. Anterior volume (LA-A: 112 ± 48 vs. 83 ± 26 ml, p < 0.001) differed significantly between groups, whereas the posterior volume LA-P (55 ± 28 vs. 47 ± 13 ml, p = 0.23) and LAS (75% vs. 78%, p = 0.089) was similar in both groups. As a result, ASI was significantly higher (67 ± 6 vs. 63 ± 6%, p = 0.01) in HCM than in Non-HCM patients. In conclusion, LA remodeling in patients with AF and HCM is characterized by asymmetric dilatation, driven by an anterior rather than a posterior dilatation. This can be characterized by three-dimensional imaging and could be used as surrogate of advanced atrial remodeling.
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影响因子：
5.4
作者：
Dinshaw L;Münkler P;Schäffer B;Klatt N;Jungen C;Dickow J;Tamenang A;Schleberger R;Pecha S;Pinnschmidt H;Patten M;Reichenspurner H;Willems S;Meyer C
通讯作者：
Meyer C
影响因子：
6.2
作者：
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通讯作者：
Voigt, Jens-Uwe
影响因子：
2.8
作者：
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通讯作者：
Takeyasu, Noriyuki
影响因子：
2.5
作者：
Muessigbrodt, Andreas;Kosiuk, Jedrzej;Hindricks, Gerhard
通讯作者：
Hindricks, Gerhard
影响因子：
6.1
作者：
Creta, Antonio;Elliott, Perry;Providencia, Rui
通讯作者：
Providencia, Rui