Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study

Abstract Background Atrial fibrillation (AF) patients without coronary artery stenosis often show clinical evidence of ischemia. However myocardial perfusion in AF patients has been poorly studied. The purposes of this study were to investigate altered hyperemic myocardial blood flow (MBF) in patien...

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Autores principales:	Masafumi Takafuji, Kakuya Kitagawa, Satoshi Nakamura, Takanori Kokawa, Yoshihiko Kagawa, Satoshi Fujita, Tomoyuki Fukuma, Eitaro Fujii, Kaoru Dohi, Hajime Sakuma
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	atrial fibrillation CT delayed enhancement dual‐source CT dynamic CT perfusion myocardial blood flow Physiology QP1-981
Acceso en línea:	https://doaj.org/article/a9d721eb09074a94b7228f82e6458944
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spelling	oai:doaj.org-article:a9d721eb09074a94b7228f82e64589442021-11-27T15:48:30ZHyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study2051-817X10.14814/phy2.15123https://doaj.org/article/a9d721eb09074a94b7228f82e64589442021-11-01T00:00:00Zhttps://doi.org/10.14814/phy2.15123https://doaj.org/toc/2051-817XAbstract Background Atrial fibrillation (AF) patients without coronary artery stenosis often show clinical evidence of ischemia. However myocardial perfusion in AF patients has been poorly studied. The purposes of this study were to investigate altered hyperemic myocardial blood flow (MBF) in patients with AF compared with risk‐matched controls in sinus rhythm (SR), and to evaluate hyperemic MBF before and after catheter ablation using dynamic CT perfusion. Methods Hyperemic MBF was quantified in 87 patients with AF (44 paroxysmal, 43 persistent) scheduled for catheter ablation using dynamic CT perfusion, and compared with hyperemic MBF in 87 risk‐matched controls in SR. Follow‐up CT after ablation was performed in 49 AF patients. Results Prior to ablation, hyperemic MBF of patients in AF during the CT (1.29 ± 0.34 ml/mg/min) was significantly lower than in patients in SR (1.49 ± 0.26 ml/g/min, p = 0.002) or matched controls (1.65 ± 0.32 ml/g/min, p < 0.001); no significant difference was seen between patients in SR during the CT and matched controls (vs. 1.50 ± 0.31 ml/g/min, p = 0.815). In patients in AF during the pre‐ablation CT (n = 24), hyperemic MBF significantly increased after ablation from 1.30 ± 0.35 to 1.53 ± 0.17 ml/g/min (p = 0.004); whereas in patients in SR during the pre‐ablation CT (n = 25), hyperemic MBF did not change significantly after ablation (from 1.46 ± 0.26 to 1.49 ± 0.27 ml/g/min, p = 0.499). Conclusion In the current study using stress perfusion CT, hyperemic MBF in patients with AF during pre‐ablation CT was significantly lower than that in risk‐matched controls, and improved significantly after restoration of SR by catheter ablation, indicating that MBF abnormalities in AF patients are caused primarily by AF itself.Masafumi TakafujiKakuya KitagawaSatoshi NakamuraTakanori KokawaYoshihiko KagawaSatoshi FujitaTomoyuki FukumaEitaro FujiiKaoru DohiHajime SakumaWileyarticleatrial fibrillationCT delayed enhancementdual‐source CTdynamic CT perfusionmyocardial blood flowPhysiologyQP1-981ENPhysiological Reports, Vol 9, Iss 22, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial fibrillation CT delayed enhancement dual‐source CT dynamic CT perfusion myocardial blood flow Physiology QP1-981
spellingShingle	atrial fibrillation CT delayed enhancement dual‐source CT dynamic CT perfusion myocardial blood flow Physiology QP1-981 Masafumi Takafuji Kakuya Kitagawa Satoshi Nakamura Takanori Kokawa Yoshihiko Kagawa Satoshi Fujita Tomoyuki Fukuma Eitaro Fujii Kaoru Dohi Hajime Sakuma Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study
description	Abstract Background Atrial fibrillation (AF) patients without coronary artery stenosis often show clinical evidence of ischemia. However myocardial perfusion in AF patients has been poorly studied. The purposes of this study were to investigate altered hyperemic myocardial blood flow (MBF) in patients with AF compared with risk‐matched controls in sinus rhythm (SR), and to evaluate hyperemic MBF before and after catheter ablation using dynamic CT perfusion. Methods Hyperemic MBF was quantified in 87 patients with AF (44 paroxysmal, 43 persistent) scheduled for catheter ablation using dynamic CT perfusion, and compared with hyperemic MBF in 87 risk‐matched controls in SR. Follow‐up CT after ablation was performed in 49 AF patients. Results Prior to ablation, hyperemic MBF of patients in AF during the CT (1.29 ± 0.34 ml/mg/min) was significantly lower than in patients in SR (1.49 ± 0.26 ml/g/min, p = 0.002) or matched controls (1.65 ± 0.32 ml/g/min, p < 0.001); no significant difference was seen between patients in SR during the CT and matched controls (vs. 1.50 ± 0.31 ml/g/min, p = 0.815). In patients in AF during the pre‐ablation CT (n = 24), hyperemic MBF significantly increased after ablation from 1.30 ± 0.35 to 1.53 ± 0.17 ml/g/min (p = 0.004); whereas in patients in SR during the pre‐ablation CT (n = 25), hyperemic MBF did not change significantly after ablation (from 1.46 ± 0.26 to 1.49 ± 0.27 ml/g/min, p = 0.499). Conclusion In the current study using stress perfusion CT, hyperemic MBF in patients with AF during pre‐ablation CT was significantly lower than that in risk‐matched controls, and improved significantly after restoration of SR by catheter ablation, indicating that MBF abnormalities in AF patients are caused primarily by AF itself.
format	article
author	Masafumi Takafuji Kakuya Kitagawa Satoshi Nakamura Takanori Kokawa Yoshihiko Kagawa Satoshi Fujita Tomoyuki Fukuma Eitaro Fujii Kaoru Dohi Hajime Sakuma
author_facet	Masafumi Takafuji Kakuya Kitagawa Satoshi Nakamura Takanori Kokawa Yoshihiko Kagawa Satoshi Fujita Tomoyuki Fukuma Eitaro Fujii Kaoru Dohi Hajime Sakuma
author_sort	Masafumi Takafuji
title	Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study
title_short	Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study
title_full	Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study
title_fullStr	Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study
title_full_unstemmed	Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study
title_sort	hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: a dynamic stress ct perfusion study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/a9d721eb09074a94b7228f82e6458944
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_version_	1718408522288332800

Hyperemic myocardial blood flow in patients with atrial fibrillation before and after catheter ablation: A dynamic stress CT perfusion study

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