Prognostic and functional implications of left atrial late gadolinium enhancement cardiovascular magnetic resonance.
Atrial Fibrillation
/ diagnostic imaging
Atrial Function, Left
Atrial Remodeling
Contrast Media
/ administration & dosage
Fibrosis
Heart Atria
/ diagnostic imaging
Humans
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Organometallic Compounds
/ administration & dosage
Predictive Value of Tests
Prognosis
Reproducibility of Results
Retrospective Studies
Risk Factors
Ventricular Function, Left
Atrial fibrillation
Cardiovascular magnetic resonance
Ejection fraction
Late gadolinium enhancement
Left atrium
Journal
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
ISSN: 1532-429X
Titre abrégé: J Cardiovasc Magn Reson
Pays: England
ID NLM: 9815616
Informations de publication
Date de publication:
03 01 2019
03 01 2019
Historique:
received:
07
06
2018
accepted:
04
12
2018
entrez:
4
1
2019
pubmed:
4
1
2019
medline:
20
12
2019
Statut:
epublish
Résumé
Left atrial (LA) late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging is indicative of fibrosis, and has been correlated with reduced LA function, increased LA volume, and poor procedural outcomes in cohorts with atrial fibrillation (AF). However, the role of LGE as a prognostic biomarker for arrhythmia in cardiac disease has not been examined. In this study, we assessed LA LGE using a 3D LGE CMR sequence to examine its relationships with new onset atrial arrhythmia, and LA and left ventricular (LV) mechanical function. LA LGE images were acquired in 111 patients undergoing CMR imaging, including 66 patients with no prior history of an atrial arrhythmia. During the median follow-up of 2.7 years (interquartile range (IQR) 1.8-3.7 years), 15/66 (23%) of patients developed a new atrial arrhythmia. LA LGE ≥10% of LA myocardial volume was significantly associated with an increased rate of new-onset atrial arrhythmia, with a hazard ratio of 3.16 (95% CI 1.14-8.72), p = 0.026. There were significant relationships between LA LGE and both LA ejection fraction (r = - 0.39, p < 0.0005) and echocardiographic LV septal e' (r = - 0.24, p = 0.04) and septal E/e' (r = 0.31, p = 0.007). Elevated LA LGE is associated with reduced LA function and reduced LV diastolic function. LA LGE is associated with new onset atrial arrhythmia during follow-up.
Sections du résumé
BACKGROUND
Left atrial (LA) late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging is indicative of fibrosis, and has been correlated with reduced LA function, increased LA volume, and poor procedural outcomes in cohorts with atrial fibrillation (AF). However, the role of LGE as a prognostic biomarker for arrhythmia in cardiac disease has not been examined.
METHODS
In this study, we assessed LA LGE using a 3D LGE CMR sequence to examine its relationships with new onset atrial arrhythmia, and LA and left ventricular (LV) mechanical function.
RESULTS
LA LGE images were acquired in 111 patients undergoing CMR imaging, including 66 patients with no prior history of an atrial arrhythmia. During the median follow-up of 2.7 years (interquartile range (IQR) 1.8-3.7 years), 15/66 (23%) of patients developed a new atrial arrhythmia. LA LGE ≥10% of LA myocardial volume was significantly associated with an increased rate of new-onset atrial arrhythmia, with a hazard ratio of 3.16 (95% CI 1.14-8.72), p = 0.026. There were significant relationships between LA LGE and both LA ejection fraction (r = - 0.39, p < 0.0005) and echocardiographic LV septal e' (r = - 0.24, p = 0.04) and septal E/e' (r = 0.31, p = 0.007).
CONCLUSIONS
Elevated LA LGE is associated with reduced LA function and reduced LV diastolic function. LA LGE is associated with new onset atrial arrhythmia during follow-up.
Identifiants
pubmed: 30602395
doi: 10.1186/s12968-018-0514-3
pii: 10.1186/s12968-018-0514-3
pmc: PMC6317232
doi:
Substances chimiques
Contrast Media
0
Organometallic Compounds
0
gadobutrol
1BJ477IO2L
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2Subventions
Organisme : British Heart Foundation
ID : FS/16/28/32327
Pays : United Kingdom
Organisme : NHLBI NIH HHS
ID : R01 HL122560
Pays : United States
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