Journal article
Atrial fibrosis in non-atrial fibrillation individuals and prediction of atrial fibrillation by use of late gadolinium enhancement magnetic resonance imaging
Journal of cardiovascular electrophysiology, Vol.30(4), pp.550-556
04/01/2019
DOI: 10.1111/jce.13846
PMID: 30661270
Abstract
Introduction Besides the traditional concept of atrial fibrillation (AF) perpetuating atrial structural remodeling, there is increasing evidence that atrial fibrosis might precede AF, highlighting the need for better characterization of the fibrotic substrate. We aimed to assess atrial fibrosis by use of late gadolinium enhancement magnetic resonance imaging (LGE-MRI) in non-AF individuals and to identify predisposing risk factors. A second aim was to establish a risk score for the prevalence of AF using atrial fibrosis in addition to established clinical variables. Methods and Results Non-AF individuals without structural heart disease (n = 91) and matched AF controls (n = 91) underwent MRI for assessment of LGE. According to the established UTAH classification, atrial LGE >= 20% was considered extensive. Mean left atrial (LA) fibrosis in non-AF and AF individuals were 8.8 +/- 6.5% and 12.5 +/- 5.8%, respectively. Body mass index (BMI) >30 kg/m(2) and LA volume were predictors of atrial fibrosis. Diastolic function was not significantly different with respect to atrial fibrosis. A novel scoring system for the prevalence of AF (2 points for arterial hypertension and/or left ventricular ejection fraction 6%) was derived demonstrating that patients in the intermediate/high-risk group had a significantly increased risk of AF. Conclusion This study reports unexpectedly high atrial fibrosis in non-AF patients without apparent heart disease, highlighting the concept that structural fibrotic alterations may precede AF onset in a significant proportion of individuals. BMI as a predictor of atrial fibrosis suggests that lifestyle and drug intervention, that is, weight reduction, could positively influence fibrosis development. The derived risk score for AF prevalence provides the basis for prospective studies on AF incidence.
Details
- Title: Subtitle
- Atrial fibrosis in non-atrial fibrillation individuals and prediction of atrial fibrillation by use of late gadolinium enhancement magnetic resonance imaging
- Creators
- Johannes Siebermair - Comprehensive Arrhythmia Research & Management Center Salt Lake City UtahPromporn Suksaranjit - University of IowaChristopher J. McGann - Comprehensive Arrhythmia Research & Management Center Salt Lake City UtahKathryn A. Peterson - University of UtahMobin Kheirkhahan - Comprehensive Arrhythmia Research & Management Center, Salt Lake City, Utah.Alex A. Baher - University of UtahKavitha Damal - Comprehensive Arrhythmia Research & Management Center, Salt Lake City, Utah.Reza Wakili - West German Heart and Vascular Center EssenNassir F. Marrouche - University of UtahBrent D. Wilson - University of Utah
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular electrophysiology, Vol.30(4), pp.550-556
- Publisher
- Wiley
- DOI
- 10.1111/jce.13846
- PMID
- 30661270
- ISSN
- 1045-3873
- eISSN
- 1540-8167
- Number of pages
- 7
- Language
- English
- Date published
- 04/01/2019
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984360155002771
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