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Title: | Preferential regional distribution of atrial fibrosis in posterior wall around left inferior pulmonary vein as identified by late gadolinium enhancement cardíac magnetic resonance in patients with atrial fibrillation |
Author: | Benito, Eva Cabanelas, Nuno Nuñez-Garcia, Marta Alarcón, Francisco Figueras i Ventura, Rosa M. Soto Iglesias, David Guasch i Casany, Eduard Prat González, Susanna Perea Palazón, Rosario Jesús Borràs, Roger Butakoff, Constantine Camara, Oscar Bisbal, Felipe Arbelo, Elena Tolosana, José M. (José María) Brugada Terradellas, Josep, 1958- Berruezo Sánchez, Antonio Mont Girbau, Lluís |
Keywords: | Ressonància magnètica Malalties del cor Fibril·lació auricular Magnetic resonance Heart diseases Atrial fibrillation |
Issue Date: | 1-Dec-2018 |
Publisher: | Oxford University Press |
Abstract: | Aims: Left atrial (LA) fibrosis can be identified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) in patients with atrial fibrillation (AF). However, there is limited information about anatomical fibrosis distribution in the left atrium. The aim is to determine whether there is a preferential spatial distribution of fibrosis in the left atrium in patients with AF. Methods and results: A 3-Tesla LGE-CMR was performed in 113 consecutive patients referred for AF ablation. Images were post-processed and analysed using ADAS-AF software (Galgo Medical), which allows fibrosis identification in 3D colour-coded shells. A regional semiautomatic LA parcellation software was used to divide the atrial wall into 12 segments: 1-4, posterior wall; 5-6, floor; 7, septal wall; 8-11, anterior wall; 12, lateral wall. The presence and amount of fibrosis in each segment was obtained for analysis. After exclusions for artefacts and insufficient image quality, 76 LGE-MRI images (68%) were suitable for fibrosis analysis. Segments 3 and 5, closest to the left inferior pulmonary vein, had significantly higher fibrosis (40.42% ± 23.96 and 25.82% ± 21.24, respectively; P < 0.001), compared with other segments. Segments 8 and 10 in the anterior wall contained the lowest fibrosis (2.54% ± 5.78 and 3.82% ± 11.59, respectively; P < 0.001). Age >60 years was significantly associated with increased LA fibrosis [95% confidence interval (CI) 0.19-8.39, P = 0.04] and persistent AF approached significance (95% CI -0.19% to 7.83%, P = 0.08). Conclusion: In patients with AF, the fibrotic area is preferentially located at the posterior wall and floor around the antrum of the left inferior pulmonary vein. Age >60 years was associated with increased fibrosis. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1093/europace/euy095 |
It is part of: | Europace, 2018, vol. 20, num. 12, p. 1959-1965 |
URI: | http://hdl.handle.net/2445/132064 |
Related resource: | https://doi.org/10.1093/europace/euy095 |
ISSN: | 1099-5129 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Medicina) |
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