Diffuse left atrial fibrosis according to LGE MRI in patients with atrial fibrillation, patients with hypertension and healthy volunteers

Congress:

ESCR 2015

Poster Number:

P-0005

Type:

Scientific Poster

Keywords:

Cardiac, Computer applications, Cardiovascular system, MR, Contrast agent-intravenous, Segmentation, Tissue characterisation

Authors:

O. Aparina, O. Stukalova, N. Mironova, S. P. Golitsyn, R. Bakhtiozin; Moscow/RU

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 2: LGE image aquisition and processing protocol

Fig. 3: Diffuse enhancement ratio values in patients with atrial fibrillation and...

Fig. 4: Diffuse enhancement ratio correlations in patients with atrial fibrillation and...

Fig. 1: Study population

Purpose

Study background: effective treatment of atrial fibrillation (AF) requires atrial structural remodeling evaluation. Diffuse atrial fibrosis may influence the disease progression, however it’s features in AF remain still unclear. Aim: to assess the diffuse fibrosis of left atrium (LA) in patients with atrial fibrillation and healthy volunteers (HV).

Methods and Materials

Materials and methods: 53 patients with AF (AFp) during sinus and 23 HV rhythm underwent CMR on 1,5T MRI scanner, including LGE MRI of atria (voxel size reconstructed to 0,625x0,625x2,5mm) 15 min after contrast injection. From cine-MRI LA ejection fraction (EF), LA volume (LAV) and left ventricle (LV) diastolic index were calculated. From LGE MRI images LA walls were segmented semiautomatically. Quantitative characteristic of diffuse LA fibrosis was mean atrial wall signal intensity to mean blood intensity ratio (diffuse enhancement ratio, DER).

Results

Results: AFp had higher LAV and lower LA EF than HV (79 [65,5; 86,6] ml vs. 59 [54; 78] ml, 44,5 [34,5, 54,5] % vs. 56,1 [49; 63,2] %, respectively). AFp had more intensive diffuse LA enhancement (DER) than HV (1,141 [1,059; 1,224] vs. 0,986 [0,931;1,054]). In AFp DER correlated with LAV (r=0,29, p=0,03) and LA EF (r=-0,3, p=0,01). In HV DER correlated with age (r=0,45, р=0,03) and LV diastolic index (r=0,48, р=0,02).

Conclusion

Conclusions: AF may be associated with diffuse LA fibrosis. LA fibrosis may lead to progression of LA dilatation and contractile dysfunction. In HV mild diffuse LA fibrosis may be the result of aging and LV diastolic function decrease.

References

1. Platonov P. G., Mitrofanova L. B., Orshanskaya V., Ho S. Y. Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age // J Am Coll Cardiol. ‒ 2011. ‒ T. 58, № 21. ‒ C. 2225-32. 2. Oakes R. S., Badger T. J., Kholmovski E. G., Akoum N., Burgon N. S., Fish E. N., Blauer J. J., Rao S. N., DiBella E. V., Segerson N. M., Daccarett M., Windfelder J., McGann C. J., Parker D., MacLeod...