Паттерны магнитно-резонансной томографии, ассоциированные с фибрилляцией предсердий, у пациентов с гипертрофической кардиомиопатией

Authors: O.Yu. Dariy, S.A. Aleksandrova, D.A. Malenkov, V.S. Bereznitskiy, L.A. Yurpol’skaya, V.N. Makarenko, L.A. Bockeria

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Heading: Original articles

UDC: 616.132.2:616.127-007.61
DOI: https://doi.org/10.24022/1997-3187-2018-12-4-328-340

For citation: Dariy O.Yu., Aleksandrova S.A., Malenkov D.A., Bereznitskiy V.S., Yurpol’skaya L.A., Makarenko V.N., Bockeria L.A. Magnetic-resonance myocardium mapping in hypertrophic cardiomyopathy associated with atrial fibrillation. Creative Cardiology. 2018; 12 (4): 328–40 (in Russ.). DOI: 10.24022/1997-3187-2018-12-4-328-340

Received / Accepted:  09.11.2018/12.11.2018

Key Words: magnetic resonance imaging hypertrophic cardiomyopathy atrial fibrillation Т1-map

Abstract

Objective. To identify magnetic resonance (MR) predictors associated with atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM).

Material and methods. We performed 30 cardiac magnetic resonance studies on Achieva TX 3T scanner at 2 groups of patients. The 1st (n=16) group included patients with HCM and AF and 2d group (n=14) – HCM without AF. Modified Look-Locker Inversion Recovery (MOLLI) T1 maps and late-enhancement (LGE) images were obtained for interatrial septum (IAS) and 3 short axis slices of left ventricle. Statistical analysis was performed using Spearman’s Rank correlation coefficient.

Results. Mean native IAS myocardial T1 values at 1st group patient was around 1649±135 ms, significantly higher versus the 2d group – 1343±203 ms (p<0,05). We obtained the shortness of the post-contrast IAS myocardium T1 at 1st group patients (341±40 ms), versus to 2d – 363±58 ms (p<0,05). ECV IAS at 1st group patients was 57,9±7%, at 2d – 62,3±8%. The correlation of AF and native T1 had been found statistically significant (r=0,679, p<0,05). High positive correlation of AF and left atrium (LA) volume r=0,739, p<0,05. There was weak correlation of AF from ECV (r=0,18, p<0,05). ROC-analyze gave a good model of native IAS myocardial T1 and LA volume for assume AF development at patients with HCM: AUC=0,806±0,104, cut-off 1410 ms and AUC=0,879±0,070, cut-off point 78,78 ml respectively.

Conclusions. Our study established the increase of IAS T1 relaxation time at patients with HCM and AF. There was no significant difference in the ECV in patient groups. Availability AF depends on native T1 mean and LA volume and is independent of ECV.

References

  1. Агеев Ф.Т., Габрусенко С.А., Постнов А.Ю. Акчурин Р.С., Смирнова М.Д., Карпов Р.С. и др. Клинические рекомендации по диагностике и лечению кардиомиопатий (гипертрофическая). Евразийский кардиологический журнал. 2014; 3: 5–23.
  2. Link M.S. Avoid atrial fibrillation in patients with hypertrophic cardiomyopathy. Cardiology. 2014; 127 (1): 51–2. DOI: 10.1159/000355167
  3. Бокерия Л.А., Бокерия О.Л., Климчук И.Я., Санакоев М.К. Хирургическая коррекция обструктивной гипертрофической кардиомиопатии с SAM-синдромом и фибрилляцией предсердий. Анналы аритмологии. 2016; 13 (4): 216–21. DOI: 10.15275/annaritmol.2016.4.4
  4. Guttmann O.P., Rahman M.S., O’Mahony C., Anastasakis A., Elliot P. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy systematic review. Heart. 2013; 10: 276–304. DOI: 10.1136/heartjnl-2013-304276
  5. Бокерия Л.А., Бокерия О.Л., Берсенева М.И., Тетвадзе И.В., Маленков Д.А. Предикторы развития фибрилляции предсердий у пациентов после хирургической коррекции гипертрофической обструктивной кардиомиопатии. Анналы аритмологии. 2013; 10 (S2): 265. DOI: 10.15275/annaritmol.2016.4.4
  6. McKenna W.J., England D., England D., Oackley C., Goodwin J.F. Arrhythmia in hypertrophic cardiomyopathy: influence in prognosis. Br. Heart J. 1981; 46: 168–72.
  7. Daccarett M., Badger T.J., Akoum N., Burgon N.S., Mahnkopf C., Vergara G. et al. Association of left atrial fibrosis detected by delayed-enhancement magnetic resonance imaging and the risk of stroke in patients with atrial fibrillation. J. Am. Coll. Cardiol. 2011; 57: 831–8. PubMed: 21310320. DOI: 10.1016/j.jacc.2010.09.049
  8. Oakes R.S., Badger T.J., Kholmovski E.G., Akoum N., Burgon N.S., Fish E.N. et al. Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation. 2009; 119: 1758–67. PubMed: 19307477. DOI: 10.1161/CIRCULATIONAHA.108.811877
  9. Myerson S.G., Francis J.M., Neubauer S. Cardiovascular magnetic resonance: Oxford specialist handbooks in cardiology. OUP Oxford; 2010.
  10. Herzog B., Greenwood J., Plein S. Cardiomagnetic resonanse (CMR): Pocket Guide. The ESC Working group on Cardiovascular Magnetic Resonance; 2013.
  11. Стукалова О.В., Апарина О.П., Пархоменко Д.В., Терновой С.К. Оценка структурных изменений миокарда левого предсердия у больных мерцательной аритмией методом магнитно-резонансной томографии с отстроченным контрастированием. Российский кардиологический журнал. 2014; 4: 7–15. DOI: 10.15829/1560-4071-2018-7-32-40
  12. Verma A., Wazni O.M., Marrouche N.F., Martin D.O., Kilicaslan F., Minor S. et al. Pre-existent left atrial scarring in patients undergoing pulmonary vein antrum isolation: an independent predictor of procedural failure. J. Am. Coll. Cardiol. 2005; 45: 285–292. PubMed: 15653029
  13. McGann C.J., Kholmovski E.G., Oakes R.S. et al. New magnetic resonance imaging-based method for defining the extent of left atrial wall injury after the ablation of atrial fibrillation. J. Am. Coll. Cardiol. 2008; 52: 1263–71. PubMed: 18926331. DOI: 10.1016/j.jacc.2004.10.035
  14. Sibley C.T., Noureldin R.A., Gai N., Nacif M.S., Liu S., Turkbey E.B. et al. T1 Mapping in cardiomyopathy at cardiac MR: comparison with endomyocardial biopsy. Radiology. 2012; 265: 724–32. PubMed: 23091172. DOI: 10.1136/OPENHRT-2017-000717
  15. Amano Y., Takayama M., Kumita S. Contrastenhanced myocardial T1-weighted scout (Look- Locker) imaging for the detection of myocardial damages in hypertrophic cardiomyopathy. J. Magn. Reson. Imaging. 2009; 30: 778–84. PubMed: 19787718
  16. Iles L., Pfluger H., Phrommintikul A., Cherayath J., Aksit P., Gupta S. et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping. J. Am. Coll. Cardiol. 2008; 52: 1574–80. PubMed: 19007595. DOI: 10.1016/j.jacc.2008.06.049
  17. Beinart R., Khurram I., Liu S., Yarmohammadi H., Halperin H., Bluemke D. et al. Cardiac magnetic resonance T1 mapping of left atrial myocardium. Heart Rhythm. 2013; 10 (9): 1325–31. DOI: 10.1016/j.hrthm.2013.05.003
  18. Yamaji K., Fujimoto S., Yutani C., Ikeda Y., Mizuno R., Hashimoto T., Nakamura S. Does the progression of myocardial fibrosis lead to atrial fibrillation in patients with hypertrophic cardiomyopathy? Cardiovasc. Pathol. 2001, 10: 297–303. DOI: 10.1016/j.hrthm.2013.05.003
  19. Olivotto I., Cecchi F., Casey S.A., Dolara A., Traverse J.H., Maron B.J. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation. 2001; 104: 2517–24.
  20. Doesch Ch., Lossnitzer D., Rudic B., Tueluemen E., Budjan J., Haubenreisser H. et al. Right ventricular and right atrial involvement canpredict atrial fibrillation in patients with hypertrophic cardiomyopathy? Int. J. Med. Sci. 2016; 13 (1): 1–7. DOI: 10.7150/ijms.13530

About Authors

  • Ol’ga Yu. Dariy, Radiologist, orcid.org/0000-0003-0140-8166;
  • Svetlana A. Aleksandrova, Cand. Med. Sc., Senior Researcher, orcid.org/0000-0002-7795-9709;
  • Dmitriy A. Malenkov, Cardiovascular Surgeon, Junior Researcher, orcid.org/0000-0003-4656-0209;
  • Vladimir S. Bereznitskiy, Junior Researcher, orcid.org/0000-0003-1942-5749;
  • Lyudmila A. Yurpol’skaya, Dr Med. Sc., Leading Researcher, orcid.org/0000-0001-7780-2405;
  • Vladimir N. Makarenko, Dr Med. Sc., Professor, Head of Department, orcid.org/0000-0002-8700-7592;
  • Leo A. Bockeria, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director, orcid.org/0000-0002-6180-2619

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery