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.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.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.doi http://dx.doi.org/10.1093/europace/euy095
• dc.identifier.issn 1099-5129
• dc.identifier.uri http://hdl.handle.net/10230/48085
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.relation.ispartof EP Europace. 2018;20(12):1959-65
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/633196
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/DPI2015-71640-R
• 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.rights.accessRights info:eu-repo/semantics/openAccess
• 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.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.type.version info:eu-repo/semantics/acceptedVersion