Prognostic role of left atrial fibrosis assessment using magnetic resonance imaging in patients with atrial fibrillation after catheter pulmonary vein isolation
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
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Type: Original articles
DOI:
For citation: Abgaryan A.A., Berdibekov B.Sh., Aleksandrova S.A., Ivanova Z.Z., Bulaeva N.I., Tarasova K.A., Dzhidzalova D.Kh., Romanchuk D.V., Golukhova E.Z. Prognostic role of left atrial fibrosis assessment using magnetic resonance imaging in patients with atrial fibrillation after catheter pulmonary vein isolation. Creative Cardiology. 2024; 18 (1): 92–103 (in Russ.). DOI: 10.24022/1997-3187-2024-18-1-92-103
Received / Accepted: 19.01.2024 / 05.03.2024
Keywords: atrial fibrillation left atrial fibrosis pulmonary vein isolation magnetic resonance imaging
Abstract
Objective. To investigate the relationship between the grade of left atrial (LA) fibrosisand the risk of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI).
Material and methods. This retrospective study included 34 patients with AF after PVI. The mean age of the patients was 67.1±10.1 years, 17 (50%) patients were male. The primary endpoint of the study was the development of AF recurrence in the remote period after PVI. All patients underwent time-delayed contrast-enhanced MRI before PVI to assess the grade of LA fibrosis. Cox regression analysis was performed to identify predictors of AF recurrence.
Results. At a median follow-up of 12 [12–24] months, AF recurrence was reported in nine (26.5%) patients. In ROC curve analysis, the threshold value of the left atrial volume index (LAVI) for predicting recurrent AF was 70 ml/m² (area under the curve 0.823±0.076; 95% confidence interval (CI) 0.67–0.97), and 19.5% for the degree of LA fibrosis (area under the curve 0.843±0.086; 95% CI 0.67–1.00). In multivariate Cox regression analysis, indexed LA volume (hazard ratio (HR) 1.05; 95% CI 1.01–1.09; p=0.009) and the degree of LA myocardial fibrosis (HR 1.13; 95% CI 1.01–1.26; p=0.028) were independent predictors of recurrent AF.
Conclusion. The extent of LA fibrosis is an independent predictor of arrhythmia recurrence in patients with AF undergoing PVI.
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About Authors
- Anna A. Abgaryan, Postgraduate, Cardiologist; ORCID
- Bektur Sh. Berdibekov, Junior Researcher, Cardiologist; ORCID
- Svetlana A. Aleksandrova, Cand. Med. Sci., Senior Researcher; ORCID
- Zalina Z. Ivanova, Radiologist; ORCID
- Naida I. Bulaeva, Cand. Biol. Sci., Associate Professor, Head of Department, Cardiologist; ORCID
- Kseniya A. Tarasova, Postgraduate; ORCID
- Diana Kh. Dzhidzalova, Cardiologist; ORCID
- Denis V. Romanchuk, Postgraduate; ORCID
- Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of RAS, Director; ORCID