Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis

Abstract Background Atrial fibrillation (AF) is associated with profound structural and functional changes in the atria. In the present study, we investigated the association between left atrial (LA) phasic function and the extent of LA fibrosis using advanced cardiovascular magnetic resonance (CMR)...

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Autores principales:	Luuk H. G. A. Hopman, Mark J. Mulder, Anja M. van der Laan, Ahmet Demirkiran, Pranav Bhagirath, Albert C. van Rossum, Cornelis P. Allaart, Marco J. W. Götte
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Atrial remodeling Atrial fibrillation Atrial strain Atrial fibrosis Cardiovascular magnetic resonance (CMR) Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/e35ca842637c4c11be59cd57c0589c97
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spelling	oai:doaj.org-article:e35ca842637c4c11be59cd57c0589c972021-11-14T12:12:49ZImpaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis10.1186/s12968-021-00820-61532-429Xhttps://doaj.org/article/e35ca842637c4c11be59cd57c0589c972021-11-01T00:00:00Zhttps://doi.org/10.1186/s12968-021-00820-6https://doaj.org/toc/1532-429XAbstract Background Atrial fibrillation (AF) is associated with profound structural and functional changes in the atria. In the present study, we investigated the association between left atrial (LA) phasic function and the extent of LA fibrosis using advanced cardiovascular magnetic resonance (CMR) imaging techniques, including 3-dimensional (3D) late gadolinium enhancement (LGE) and feature tracking. Methods Patients with paroxysmal and persistent AF (n = 105) underwent CMR in sinus rhythm. LA global reservoir strain, conduit strain and contractile strain were derived from cine CMR images using CMR feature tracking. The extent of LA fibrosis was assessed from 3D LGE images. Healthy subjects underwent CMR and served as controls (n = 19). Results Significantly lower LA reservoir strain, conduit strain and contractile strain were found in AF patients, as compared to healthy controls (− 15.9 ± 3.8% vs. − 21.1 ± 3.6% P < 0.001, − 8.7 ± 2.7% vs. − 12.6 ± 2.5% P < 0.001 and − 7.2 ± 2.3% vs. − 8.6 ± 2.2% P = 0.02, respectively). Patients with a high degree of LA fibrosis (dichotomized by the median value) had lower reservoir strain and conduit strain compared to patients with a low degree of LA fibrosis (− 15.0 ± 3.9% vs. − 16.9 ± 3.3%, P = 0.02 and − 7.9 ± 2.7% vs. − 9.5 ± 2.6%, P = 0.01, respectively). In contrast, no difference was found for LA contractile strain (− 7.1 ± 2.4% vs. − 7.4 ± 2.3%, P = 0.55). Conclusions Impaired LA reservoir and conduit strain are present in AF patients with extensive atrial fibrosis. Future studies are needed to examine the biologic nature of this association and possible therapeutic implications.Luuk H. G. A. HopmanMark J. MulderAnja M. van der LaanAhmet DemirkiranPranav BhagirathAlbert C. van RossumCornelis P. AllaartMarco J. W. GötteBMCarticleAtrial remodelingAtrial fibrillationAtrial strainAtrial fibrosisCardiovascular magnetic resonance (CMR)Diseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Atrial remodeling Atrial fibrillation Atrial strain Atrial fibrosis Cardiovascular magnetic resonance (CMR) Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Atrial remodeling Atrial fibrillation Atrial strain Atrial fibrosis Cardiovascular magnetic resonance (CMR) Diseases of the circulatory (Cardiovascular) system RC666-701 Luuk H. G. A. Hopman Mark J. Mulder Anja M. van der Laan Ahmet Demirkiran Pranav Bhagirath Albert C. van Rossum Cornelis P. Allaart Marco J. W. Götte Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
description	Abstract Background Atrial fibrillation (AF) is associated with profound structural and functional changes in the atria. In the present study, we investigated the association between left atrial (LA) phasic function and the extent of LA fibrosis using advanced cardiovascular magnetic resonance (CMR) imaging techniques, including 3-dimensional (3D) late gadolinium enhancement (LGE) and feature tracking. Methods Patients with paroxysmal and persistent AF (n = 105) underwent CMR in sinus rhythm. LA global reservoir strain, conduit strain and contractile strain were derived from cine CMR images using CMR feature tracking. The extent of LA fibrosis was assessed from 3D LGE images. Healthy subjects underwent CMR and served as controls (n = 19). Results Significantly lower LA reservoir strain, conduit strain and contractile strain were found in AF patients, as compared to healthy controls (− 15.9 ± 3.8% vs. − 21.1 ± 3.6% P < 0.001, − 8.7 ± 2.7% vs. − 12.6 ± 2.5% P < 0.001 and − 7.2 ± 2.3% vs. − 8.6 ± 2.2% P = 0.02, respectively). Patients with a high degree of LA fibrosis (dichotomized by the median value) had lower reservoir strain and conduit strain compared to patients with a low degree of LA fibrosis (− 15.0 ± 3.9% vs. − 16.9 ± 3.3%, P = 0.02 and − 7.9 ± 2.7% vs. − 9.5 ± 2.6%, P = 0.01, respectively). In contrast, no difference was found for LA contractile strain (− 7.1 ± 2.4% vs. − 7.4 ± 2.3%, P = 0.55). Conclusions Impaired LA reservoir and conduit strain are present in AF patients with extensive atrial fibrosis. Future studies are needed to examine the biologic nature of this association and possible therapeutic implications.
format	article
author	Luuk H. G. A. Hopman Mark J. Mulder Anja M. van der Laan Ahmet Demirkiran Pranav Bhagirath Albert C. van Rossum Cornelis P. Allaart Marco J. W. Götte
author_facet	Luuk H. G. A. Hopman Mark J. Mulder Anja M. van der Laan Ahmet Demirkiran Pranav Bhagirath Albert C. van Rossum Cornelis P. Allaart Marco J. W. Götte
author_sort	Luuk H. G. A. Hopman
title	Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
title_short	Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
title_full	Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
title_fullStr	Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
title_full_unstemmed	Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
title_sort	impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e35ca842637c4c11be59cd57c0589c97
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_version_	1718429377408008192

Impaired left atrial reservoir and conduit strain in patients with atrial fibrillation and extensive left atrial fibrosis

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