Imaging, biomarker and invasive assessment of diffuse left ventricular myocardial fibrosis in atrial fibrillation

心房颤动弥漫性左心室心肌纤维化的影像学、生物标志物及侵入性评估

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作者:Gordon A Begg, Peter P Swoboda, Rashed Karim, Tobias Oesterlein, Kawal Rhode, Arun V Holden, John P Greenwood, Eduard Shantsila, Gregory Y H Lip, Sven Plein, Muzahir H Tayebjee

Background

Using cardiovascular magnetic resonance imaging (CMR), it is possible to detect diffuse fibrosis of the left ventricle (LV) in patients with atrial fibrillation (AF), which may be independently associated with recurrence of AF after ablation. By conducting CMR, clinical, electrophysiology and biomarker assessment we planned to investigate LV myocardial fibrosis in patients undergoing AF ablation.

Conclusion

LV fibrosis in patients with AF is associated with left atrial pressure and invasively measured levels of ICTP turnover biomarker.

Methods

LV fibrosis was assessed by T1 mapping in 31 patients undergoing percutaneous ablation for AF. Galectin-3, coronary sinus type I collagen C terminal telopeptide (ICTP), and type III procollagen N terminal peptide were measured with ELISA. Comparison was made between groups above and below the median for LV extracellular volume fraction (ECV), followed by regression analysis.

Results

On linear regression analysis LV ECV had significant associations with invasive left atrial pressure (Beta 0.49, P = 0.008) and coronary sinus ICTP (Beta 0.75, P < 0.001), which remained significant on multivariable regression.

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