Use of Atrial Fibrillation Electrograms and T1/T2 Magnetic Resonance Imaging to Define the Progressive Nature of Molecular and Structural Remodeling: A New Paradigm Underlying the Emergence of Persistent Atrial Fibrillation.


Journal

Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524

Informations de publication

Date de publication:
05 Mar 2024
Historique:
medline: 11 3 2024
pubmed: 6 11 2023
entrez: 6 11 2023
Statut: ppublish

Résumé

The temporal progression states of the molecular and structural substrate in atrial fibrillation (AF) are not well understood. We hypothesized that these can be detected by AF electrograms and magnetic resonance imaging parametric mapping. AF was induced in 43 dogs (25-35 kg, ≥1 year) by rapid atrial pacing (RAP) (3-33 weeks, 600 beats/min), and 4 controls were used. We performed high-resolution epicardial mapping (UnEmap, 6 atrial regions, both atria, 130 electrodes, distance 2.5 mm) and analyzed electrogram cycle length, dominant frequency, organization index, and peak-to-peak bipolar voltage. Implantable telemetry recordings were used to quantify parasympathetic nerve activity over RAP time. Magnetic resonance imaging native T1, postcontrast T1, T2 mapping, and extracellular volume fraction were assessed (1.5T, Siemens) at baseline and AF. In explanted atrial tissue, DNA oxidative damage (8-hydroxy-2'-deoxyguanosine staining) and percentage of fibrofatty tissue were quantified. Cycle length and organization index decreased ( A combination of AF electrogram characteristics and T1/T2 magnetic resonance imaging can detect early-stage AF remodeling (autonomic remodeling, oxidative stress) and advanced AF remodeling due to oxidative stress and fibrosis.

Sections du résumé

BACKGROUND BACKGROUND
The temporal progression states of the molecular and structural substrate in atrial fibrillation (AF) are not well understood. We hypothesized that these can be detected by AF electrograms and magnetic resonance imaging parametric mapping.
METHODS AND RESULTS RESULTS
AF was induced in 43 dogs (25-35 kg, ≥1 year) by rapid atrial pacing (RAP) (3-33 weeks, 600 beats/min), and 4 controls were used. We performed high-resolution epicardial mapping (UnEmap, 6 atrial regions, both atria, 130 electrodes, distance 2.5 mm) and analyzed electrogram cycle length, dominant frequency, organization index, and peak-to-peak bipolar voltage. Implantable telemetry recordings were used to quantify parasympathetic nerve activity over RAP time. Magnetic resonance imaging native T1, postcontrast T1, T2 mapping, and extracellular volume fraction were assessed (1.5T, Siemens) at baseline and AF. In explanted atrial tissue, DNA oxidative damage (8-hydroxy-2'-deoxyguanosine staining) and percentage of fibrofatty tissue were quantified. Cycle length and organization index decreased (
CONCLUSIONS CONCLUSIONS
A combination of AF electrogram characteristics and T1/T2 magnetic resonance imaging can detect early-stage AF remodeling (autonomic remodeling, oxidative stress) and advanced AF remodeling due to oxidative stress and fibrosis.

Identifiants

pubmed: 37930082
doi: 10.1161/JAHA.123.032514
pmc: PMC10944076
doi:

Substances chimiques

8-Hydroxy-2'-Deoxyguanosine 88847-89-6

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e032514

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL140061
Pays : United States
Organisme : NHLBI NIH HHS
ID : R35 HL161249
Pays : United States

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Auteurs

Markus Rottmann (M)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

Shin Yoo (S)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

Anna Pfenniger (A)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.
Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL USA.

Aleksei Mikhailov (A)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

Brandon Benefield (B)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

David A Johnson (DA)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

Wenwei Zhang (W)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

Asish K Ghosh (AK)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.

Daniel Kim (D)

Department of Radiology Northwestern University Feinberg School of Medicine Chicago IL USA.

Rod Passman (R)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.
Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL USA.

Bradley P Knight (BP)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.
Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL USA.

Daniel C Lee (DC)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.
Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL USA.
Department of Radiology Northwestern University Feinberg School of Medicine Chicago IL USA.

Rishi Arora (R)

Feinberg Cardiovascular and Renal Research Institute Northwestern University Feinberg School of Medicine Chicago IL USA.
Division of Cardiology Northwestern University Feinberg School of Medicine Chicago IL USA.

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Classifications MeSH