The novel approach to quantitative asseament of left atrial fibrosis in patents with atrial fibrillation

Congress:

ESCR 2016

Poster Number:

P-0005

Type:

Scientific Poster

Keywords:

MR, Cardiac, Anatomy, Computer Applications-3D, Contrast agent-intravenous, Image registration, Pathology

Authors:

S. K. Ternovoy, O. Stukalova, O. Aparina, D. Parkhomenko, N. Mironova; Moscow/RU

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 1: Study groups

Fig. 2: MRI images aquisition and analysis

Fig. 3: Left atrial signal intensity assessment

Fig. 6: Left atrial fibrosis in patients with atrial fibrillation and healthy volunteers

Purpose

Study background: left atrial fibrosis (LAF) quantification in new promising tool in atrial fibrillation (AF) management. However, little is known about the normal and pathological values of the late gadolinium enhancement (LGE) in LA. The aim of the study: to develop the indicators for LA LGE quantitative assessment, to evaluate LA LGE and LAF in patients with AF (AFp) and healthy volunteers (HV).

Methods and Materials

Materials and methods: 23 HV and 53 AFp during sinus rhythm underwent CMR on 1.5 T clinical scanner. LGE MRI (voxel size reconstructed to 0,625x0,625x2,5mm) was performed 15min after gadoversetamide injection. From LGE MRI images LA walls were segmented semiautomaticaly using standardized protocol for artifact exclusion. For LA LGE quantification new indicators were developed and calculated. They were mean atrial wall intensity to mean blood intensity ratio (diffuse intensity ratio, DIR) and maximum atrial wall intensity to mean blood pool intensity ratio (maximal intensity ratio,...

Results

Results: New indicators MIR and DIR were significantly higher in AFp than in HV (0,9[0,9;1,05] vs. 1,1[1,06;1,2], p<0,05; 1,6 [1,42;1,84] vs. 1,7[1,1;2], p<0,05 respectively). In AFp LAF extent was higher than in HV (9,1%[1,7%;18,5%] vs. 0,7%[0,04%;3,5%], p<0,05).

Conclusion

Use of standardized protocol for LA wall segmentation allows exclude the artifacts. New indicators DIR and MIR provide LA LGE quantification. Use of new indicators reveal and confirm differences in LGE in AFp and HV. Original algorithm adjusted LAF quantification technique based on threshold criteria obtained from healthy volunteers data is feasible in assessment of LA. AFp have significantly higher LA LGE and the extent of LAF than HV.