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Preferential regional distribution of atrial fibrosis in posterior wall around left inferior pulmonary vein as identified by late gadolinium enhancement cardiac magnetic resonance in patients with atrial fibrillation

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dc.contributor.author Benito, Eva M.
dc.contributor.author Cabanelas, Nuno
dc.contributor.author Nuñez-Garcia, Marta
dc.contributor.author Alarcón, Francisco
dc.contributor.author Figueras i Ventura, Rosa M.
dc.contributor.author Soto-Iglesias, David
dc.contributor.author Guasch, Eduard
dc.contributor.author Prat Gonzàlez, Susanna
dc.contributor.author Perea, Rosario J.
dc.contributor.author Borràs, Roger
dc.contributor.author Butakoff, Constantine
dc.contributor.author Camara, Oscar
dc.contributor.author Bisbal, Felipe
dc.contributor.author Arbelo, Elena
dc.contributor.author Tolosana, José Maria
dc.contributor.author Brugada, Josep
dc.contributor.author Berruezo Sánchez, Antonio
dc.contributor.author Mont, Lluís
dc.date.accessioned 2021-07-06T07:30:49Z
dc.date.available 2021-07-06T07:30:49Z
dc.date.issued 2018
dc.identifier.citation Benito EM, Cabanelas N, Nuñez-Garcia M, Alarcón F, Figueras i Ventura RM, Soto-Iglesias D, Guasch E, Prat-Gonzalez S, Perea RJ, Borràs R, Butakoff C, Camara O, Bisbal F, Arbelo E, Tolosana JM, Brugada J, Berruezo A, Mont L. Preferential regional distribution of atrial fibrosis in posterior wall around left inferior pulmonary vein as identified by late gadolinium enhancement cardiac magnetic resonance in patients with atrial fibrillation. EP Europace. 2018;20(12):1959-65. DOI: 10.1093/europace/euy095
dc.identifier.issn 1099-5129
dc.identifier.uri http://hdl.handle.net/10230/48085
dc.description.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.
dc.description.sponsorship This work was partially supported by Fondo de Investigaciones Sanitarias-Instituto de Salud Carlos III (PI13/01747 and PI16/00435); Agencia de gestió d´Ajuts Universitaris I de Recerca (AGAUR) Exp: 2014_SGR_471; CERCA programme/Generalitat de Catalunya; European Regional Development Fund (ERDF. European Union. A Way of Making Europe), the European Union's Horizon 2020 research and innovation programme under grant agreement No 633196 (CATCH ME), a grant by La MARATÓ-TV3 (20152730) and the Spanish Ministry of Economy and Competitiveness (DPI2015-71640-R).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof EP Europace. 2018;20(12):1959-65
dc.rights © Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in EP Europace following peer review. The version of record Benito EM, Cabanelas N, Nuñez-Garcia M, Alarcón F, Figueras i Ventura RM, Soto-Iglesias D, Guasch E, Prat-Gonzalez S, Perea RJ, Borràs R, Butakoff C, Camara O, Bisbal F, Arbelo E, Tolosana JM, Brugada J, Berruezo A, Mont L. Preferential regional distribution of atrial fibrosis in posterior wall around left inferior pulmonary vein as identified by late gadolinium enhancement cardiac magnetic resonance in patients with atrial fibrillation. EP Europace. 2018;20(12):1959-65. is available online at: http://dx.doi.org/10.1093/europace/euy095
dc.title Preferential regional distribution of atrial fibrosis in posterior wall around left inferior pulmonary vein as identified by late gadolinium enhancement cardiac magnetic resonance in patients with atrial fibrillation
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1093/europace/euy095
dc.subject.keyword Atrial fibrillation
dc.subject.keyword Fibrosis
dc.subject.keyword Late gadolinium enhancement cardiac magnetic resonance
dc.subject.keyword Regional distribution
dc.subject.keyword Risk factors
dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/633196
dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/DPI2015-71640-R
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion

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