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Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to Quantify Tissue Remodeling in Patients with Atrial Fibrillation
BACKGROUND: Recent studies suggest that left atrial (LA) late gadolinium enhancement (LGE) can quantify the underlying tissue remodeling that harbors atrial fibrillation (AF). However, quantification of LA-LGE requires labor-intensive magnetic resonance imaging acquisition and postprocessing at expe...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cardiologia - SBC
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459423/ https://www.ncbi.nlm.nih.gov/pubmed/30994724 http://dx.doi.org/10.5935/abc.20190064 |
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author | Ciuffo, Luisa Allen Lima, João de Vasconcellos, Henrique Doria Balouch, Muhammad Tao, Susumu Nazarian, Saman Spragg, David D. Marine, Joseph E. Berger, Ronald D. Calkins, Hugh Ashikaga, Hiroshi |
author_facet | Ciuffo, Luisa Allen Lima, João de Vasconcellos, Henrique Doria Balouch, Muhammad Tao, Susumu Nazarian, Saman Spragg, David D. Marine, Joseph E. Berger, Ronald D. Calkins, Hugh Ashikaga, Hiroshi |
author_sort | Ciuffo, Luisa Allen |
collection | PubMed |
description | BACKGROUND: Recent studies suggest that left atrial (LA) late gadolinium enhancement (LGE) can quantify the underlying tissue remodeling that harbors atrial fibrillation (AF). However, quantification of LA-LGE requires labor-intensive magnetic resonance imaging acquisition and postprocessing at experienced centers. LA intra-atrial dyssynchrony assessment is an emerging imaging technique that predicts AF recurrence after catheter ablation. We hypothesized that 1) LA intra-atrial dyssynchrony is associated with LA-LGE in patients with AF and 2) LA intra-atrial dyssynchrony is greater in patients with persistent AF than in those with paroxysmal AF. METHOD: We conducted a cross-sectional study comparing LA intra-atrial dyssynchrony and LA-LGE in 146 patients with a history of AF (60.0 ± 10.0 years, 30.1% nonparoxysmal AF) who underwent pre-AF ablation cardiac magnetic resonance (CMR) in sinus rhythm. Using tissue-tracking CMR, we measured the LA longitudinal strain in two- and four-chamber views. We defined intra-atrial dyssynchrony as the standard deviation (SD) of the time to peak longitudinal strain (SD-TPS, in %) and the SD of the time to the peak pre-atrial contraction strain corrected by the cycle length (SD-TPS(preA), in %). We used the image intensity ratio (IIR) to quantify LA-LGE. RESULTS: Intra-atrial dyssynchrony analysis took 5 ± 9 minutes per case. Multivariable analysis showed that LA intra-atrial dyssynchrony was independently associated with LA-LGE. In addition, LA intra-atrial dyssynchrony was significantly greater in patients with persistent AF than those with paroxysmal AF. In contrast, there was no significant difference in LA-LGE between patients with persistent and paroxysmal AF. LA intra-atrial dyssynchrony showed excellent reproducibility and its analysis was less time-consuming (5 ± 9 minutes) than the LA-LGE (60 ± 20 minutes). CONCLUSION: LA Intra-atrial dyssynchrony is a quick and reproducible index that is independently associated with LA-LGE to reflect the underlying tissue remodeling. |
format | Online Article Text |
id | pubmed-6459423 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Sociedade Brasileira de Cardiologia - SBC |
record_format | MEDLINE/PubMed |
spelling | pubmed-64594232019-04-17 Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to Quantify Tissue Remodeling in Patients with Atrial Fibrillation Ciuffo, Luisa Allen Lima, João de Vasconcellos, Henrique Doria Balouch, Muhammad Tao, Susumu Nazarian, Saman Spragg, David D. Marine, Joseph E. Berger, Ronald D. Calkins, Hugh Ashikaga, Hiroshi Arq Bras Cardiol Original Article BACKGROUND: Recent studies suggest that left atrial (LA) late gadolinium enhancement (LGE) can quantify the underlying tissue remodeling that harbors atrial fibrillation (AF). However, quantification of LA-LGE requires labor-intensive magnetic resonance imaging acquisition and postprocessing at experienced centers. LA intra-atrial dyssynchrony assessment is an emerging imaging technique that predicts AF recurrence after catheter ablation. We hypothesized that 1) LA intra-atrial dyssynchrony is associated with LA-LGE in patients with AF and 2) LA intra-atrial dyssynchrony is greater in patients with persistent AF than in those with paroxysmal AF. METHOD: We conducted a cross-sectional study comparing LA intra-atrial dyssynchrony and LA-LGE in 146 patients with a history of AF (60.0 ± 10.0 years, 30.1% nonparoxysmal AF) who underwent pre-AF ablation cardiac magnetic resonance (CMR) in sinus rhythm. Using tissue-tracking CMR, we measured the LA longitudinal strain in two- and four-chamber views. We defined intra-atrial dyssynchrony as the standard deviation (SD) of the time to peak longitudinal strain (SD-TPS, in %) and the SD of the time to the peak pre-atrial contraction strain corrected by the cycle length (SD-TPS(preA), in %). We used the image intensity ratio (IIR) to quantify LA-LGE. RESULTS: Intra-atrial dyssynchrony analysis took 5 ± 9 minutes per case. Multivariable analysis showed that LA intra-atrial dyssynchrony was independently associated with LA-LGE. In addition, LA intra-atrial dyssynchrony was significantly greater in patients with persistent AF than those with paroxysmal AF. In contrast, there was no significant difference in LA-LGE between patients with persistent and paroxysmal AF. LA intra-atrial dyssynchrony showed excellent reproducibility and its analysis was less time-consuming (5 ± 9 minutes) than the LA-LGE (60 ± 20 minutes). CONCLUSION: LA Intra-atrial dyssynchrony is a quick and reproducible index that is independently associated with LA-LGE to reflect the underlying tissue remodeling. Sociedade Brasileira de Cardiologia - SBC 2019-04 /pmc/articles/PMC6459423/ /pubmed/30994724 http://dx.doi.org/10.5935/abc.20190064 Text en http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way. |
spellingShingle | Original Article Ciuffo, Luisa Allen Lima, João de Vasconcellos, Henrique Doria Balouch, Muhammad Tao, Susumu Nazarian, Saman Spragg, David D. Marine, Joseph E. Berger, Ronald D. Calkins, Hugh Ashikaga, Hiroshi Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to Quantify Tissue Remodeling in Patients with Atrial Fibrillation |
title | Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to
Quantify Tissue Remodeling in Patients with Atrial Fibrillation |
title_full | Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to
Quantify Tissue Remodeling in Patients with Atrial Fibrillation |
title_fullStr | Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to
Quantify Tissue Remodeling in Patients with Atrial Fibrillation |
title_full_unstemmed | Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to
Quantify Tissue Remodeling in Patients with Atrial Fibrillation |
title_short | Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to
Quantify Tissue Remodeling in Patients with Atrial Fibrillation |
title_sort | intra-atrial dyssynchrony using cardiac magnetic resonance to
quantify tissue remodeling in patients with atrial fibrillation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459423/ https://www.ncbi.nlm.nih.gov/pubmed/30994724 http://dx.doi.org/10.5935/abc.20190064 |
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