Measurement of diffuse ventricular fibrosis with myocardial T1 in patients with atrial fibrillation

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• 作者：Jay A. Montgomery ; MD^a ; ^{jay.a.montgomery@vanderbilt.edu" class="auth_mail" title="E-mail the corresponding author} ; Wissam Abdallah ; MD^b ; Zachary T. Yoneda ; MD^a ; Evan Brittain ; MD ; MSCI^a ; Sam G. Aznaurov^a ; Babar Parvez ; MD^a ; Keith Adkins ; RN ; MSN^a ; S. Patrick Whalen ; MD^c ; J.C. Estrada ; MD^a ; Sharon Shen ; MD^a ; George H. Crossley ; MD^a ; Arvindh Kanagasundram ; MD^a ; Pablo Saavedra ; MD^a ; Christopher R. Ellis ; MD^a ; Mark Lawson ; MD^a ; Dawood Darbar ; MD^a ; M. Benjamin Shoemaker ; MD ; MSCI^a
• 关键词：Atrial fibrillation ; Myocardial T1 ; Cardiac MRI ; Ventricular T1 ; Atrial fibrillation ablation
• 刊名：Journal of Arrhythmia
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：32
• 期：1
• 页码：51-56
• 全文大小：475 K

文摘

Atrial fibrillation (AF) is associated with cardiac fibrosis, which can now be measured noninvasively using T1-mapping with cardiac magnetic resonance imaging (CMRI). This study aimed to assess the impact of AF on ventricular T1 at the time of CMRI.

Methods

Subjects with AF scheduled for AF ablation underwent CMRI with standard electrocardiography gating and breath-hold protocols on a 1.5 T scanner with post-contrast ventricular T1 recorded from 6 regions of interest at the mid-ventricle. Baseline demographic, clinical, and imaging characteristics were examined using univariate and multivariable linear regression modeling for an association with myocardial T1.

Results

One hundred fifty-seven patients were studied (32% women; median age, 61 years [interquartile range {IQR}, 55–67], 50% persistent AF [episodes>7 days or requiring electrical or pharmacologic cardioversion], 30% in AF at the time of the CMRI). The median global T1 was 404 ms (IQR, 381–428). AF at the time of CMRI was associated with a 4.4% shorter T1 (p=0.000) compared to sinus rhythm when adjusted for age, sex, persistent AF, body mass index, congestive heart failure, and renal dysfunction (estimated glomerular filtration rate<60). A post-hoc multivariate model adjusted for heart rate suggested that heart rate elevation (p=0.009) contributes to the reduction in T1 observed in patients with AF at the time of CMRI. No association between ventricular T1 and AF recurrence after ablation was demonstrated.

Conclusion

AF at the time of CMRI was associated with lower post-contrast ventricular T1 compared with sinus rhythm. This effect was at least partly due to elevated heart rate. T1 was not associated with the recurrence of AF after ablation.