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Left atrial remodeling in hypertrophic cardiomyopathy and susceptibility markers for atrial fibrillation identified by cardiovascular magnetic resonance.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2014 Apr 15; Vol. 113 (8), pp. 1394-400. Date of Electronic Publication: 2014 Jan 31. - Publication Year :
- 2014
-
Abstract
- In hypertrophic cardiomyopathy (HC), atrial fibrillation (AF) is an important determinant of clinical deterioration due to heart failure or embolic stroke. This study characterizes left atrial (LA) structural and functional parameters to establish markers predictive of AF risk, using cardiovascular magnetic resonance (CMR) imaging. We studied 427 consecutive patients with HC in sinus rhythm with CMR (age 44±18 years), including 41 who developed clinically overt AF after study entry (2.6±2.1 years), 49 patients with AF before CMR, 337 patients with HC but without AF, and 244 normal controls. LA chamber was assessed for absolute and indexed end-diastolic volume (LAEDV), end-systolic volume, and percent ejection fraction (LAEF). In the 41 prospectively studied patients with HC who developed AF during follow-up, LAEDV was significantly greater than in patients without AF (146±48 vs 107±37 ml) or in normal controls (81±24 ml, p<0.001). Percent LAEF was lower in patients developing AF (36±10%) than without AF (46±12%) or controls (55±9%, p<0.001). Multivariate analysis identified LAEF (<38%), LAEDV (≥118 ml), and age (≥40 years) as independently associated with AF occurrence. In conclusion, CMR measures of LA remodeling and dysfunction reliably identified patients with HC at risk for future development of AF. Decrease in LAEF represents a strong novel marker of susceptibility to AF in this disease.<br /> (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Atrial Fibrillation diagnosis
Atrial Fibrillation etiology
Cardiomyopathy, Hypertrophic complications
Cardiomyopathy, Hypertrophic diagnosis
Female
Follow-Up Studies
Heart Atria pathology
Humans
Male
Middle Aged
Prognosis
Reproducibility of Results
Retrospective Studies
Severity of Illness Index
Atrial Fibrillation physiopathology
Atrial Function, Left physiology
Atrial Remodeling physiology
Cardiomyopathy, Hypertrophic physiopathology
Heart Atria physiopathology
Magnetic Resonance Imaging, Cine methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 113
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 24589281
- Full Text :
- https://doi.org/10.1016/j.amjcard.2013.12.045