Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation

Jonathan Chrispin, Esra Gucuk Ipek, Mohammadali Habibi, Eunice Yang, David D Spragg, Joseph Marine, Hiroshi Ashikaga, John Rickard, Ronald D Berger, Stefan Zimmerman, Hugh Calkins, Saman Nazarian

Research output: Contribution to journalArticle

Abstract

Aims: This study aims to examine the association of clinical co-morbidities with the presence of left atrial (LA) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). Previous studies have established the severity of LA LGE to be associated with atrial fibrillation (AF) recurrence following AF ablation. We sought to determine whether baseline clinical characteristics were associated with LGE extent among patients presenting for an initial AF ablation. Methods and results: The cohort consisted of 179 consecutive patients with no prior cardiac ablation procedures who underwent pre-procedure LGE-CMR. The extent of LA LGE for each patient was calculated using the image intensity ratio, normalized to the mean blood pool intensity, corresponding to a bipolar voltage ≤0.3 mV. The association of LGE extent with baseline clinical characteristics was examined using non-parametric and multivariable models. The mean age of the cohort was 60.9±9.6 years and 128 (72%) were male. In total, 56 (31%) patients had persistent AF. The mean LA volume was 118.4±41.6 mL, and the mean LA LGE extent was 14.1±10.4%. There was no association with any clinical variables with LGE extent by quartiles in the multivariable model. Extent of LGE as a continuous variable was positively, but weakly associated with LA volume in a multivariable model adjusting for age, body mass index, AF persistence, and left ventricular ejection fraction (1.5% scar/mL, P = 0.038). Conclusion: In a cohort of patients presenting for initial AF ablation, the presence of pre-ablation LA LGE extent was weakly, but positively associated with increasing LA volume.

Original languageEnglish (US)
Pages (from-to)371-377
Number of pages7
JournalEuropace
Volume19
Issue number3
DOIs
StatePublished - 2017

Fingerprint

Gadolinium
Atrial Fibrillation
Magnetic Resonance Spectroscopy
Stroke Volume
Cicatrix
Body Mass Index
Morbidity
Recurrence

Keywords

  • Ablation
  • Atrial fibrillation
  • Cardiac magnetic resonance imaging
  • Delayed enhancement magnetic resonance
  • Fibrosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation. / Chrispin, Jonathan; Ipek, Esra Gucuk; Habibi, Mohammadali; Yang, Eunice; Spragg, David D; Marine, Joseph; Ashikaga, Hiroshi; Rickard, John; Berger, Ronald D; Zimmerman, Stefan; Calkins, Hugh; Nazarian, Saman.

In: Europace, Vol. 19, No. 3, 2017, p. 371-377.

Research output: Contribution to journalArticle

@article{760f5737465b42c3b0cc591d776699cd,
title = "Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation",
abstract = "Aims: This study aims to examine the association of clinical co-morbidities with the presence of left atrial (LA) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). Previous studies have established the severity of LA LGE to be associated with atrial fibrillation (AF) recurrence following AF ablation. We sought to determine whether baseline clinical characteristics were associated with LGE extent among patients presenting for an initial AF ablation. Methods and results: The cohort consisted of 179 consecutive patients with no prior cardiac ablation procedures who underwent pre-procedure LGE-CMR. The extent of LA LGE for each patient was calculated using the image intensity ratio, normalized to the mean blood pool intensity, corresponding to a bipolar voltage ≤0.3 mV. The association of LGE extent with baseline clinical characteristics was examined using non-parametric and multivariable models. The mean age of the cohort was 60.9±9.6 years and 128 (72{\%}) were male. In total, 56 (31{\%}) patients had persistent AF. The mean LA volume was 118.4±41.6 mL, and the mean LA LGE extent was 14.1±10.4{\%}. There was no association with any clinical variables with LGE extent by quartiles in the multivariable model. Extent of LGE as a continuous variable was positively, but weakly associated with LA volume in a multivariable model adjusting for age, body mass index, AF persistence, and left ventricular ejection fraction (1.5{\%} scar/mL, P = 0.038). Conclusion: In a cohort of patients presenting for initial AF ablation, the presence of pre-ablation LA LGE extent was weakly, but positively associated with increasing LA volume.",
keywords = "Ablation, Atrial fibrillation, Cardiac magnetic resonance imaging, Delayed enhancement magnetic resonance, Fibrosis",
author = "Jonathan Chrispin and Ipek, {Esra Gucuk} and Mohammadali Habibi and Eunice Yang and Spragg, {David D} and Joseph Marine and Hiroshi Ashikaga and John Rickard and Berger, {Ronald D} and Stefan Zimmerman and Hugh Calkins and Saman Nazarian",
year = "2017",
doi = "10.1093/europace/euw019",
language = "English (US)",
volume = "19",
pages = "371--377",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation

AU - Chrispin, Jonathan

AU - Ipek, Esra Gucuk

AU - Habibi, Mohammadali

AU - Yang, Eunice

AU - Spragg, David D

AU - Marine, Joseph

AU - Ashikaga, Hiroshi

AU - Rickard, John

AU - Berger, Ronald D

AU - Zimmerman, Stefan

AU - Calkins, Hugh

AU - Nazarian, Saman

PY - 2017

Y1 - 2017

N2 - Aims: This study aims to examine the association of clinical co-morbidities with the presence of left atrial (LA) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). Previous studies have established the severity of LA LGE to be associated with atrial fibrillation (AF) recurrence following AF ablation. We sought to determine whether baseline clinical characteristics were associated with LGE extent among patients presenting for an initial AF ablation. Methods and results: The cohort consisted of 179 consecutive patients with no prior cardiac ablation procedures who underwent pre-procedure LGE-CMR. The extent of LA LGE for each patient was calculated using the image intensity ratio, normalized to the mean blood pool intensity, corresponding to a bipolar voltage ≤0.3 mV. The association of LGE extent with baseline clinical characteristics was examined using non-parametric and multivariable models. The mean age of the cohort was 60.9±9.6 years and 128 (72%) were male. In total, 56 (31%) patients had persistent AF. The mean LA volume was 118.4±41.6 mL, and the mean LA LGE extent was 14.1±10.4%. There was no association with any clinical variables with LGE extent by quartiles in the multivariable model. Extent of LGE as a continuous variable was positively, but weakly associated with LA volume in a multivariable model adjusting for age, body mass index, AF persistence, and left ventricular ejection fraction (1.5% scar/mL, P = 0.038). Conclusion: In a cohort of patients presenting for initial AF ablation, the presence of pre-ablation LA LGE extent was weakly, but positively associated with increasing LA volume.

AB - Aims: This study aims to examine the association of clinical co-morbidities with the presence of left atrial (LA) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). Previous studies have established the severity of LA LGE to be associated with atrial fibrillation (AF) recurrence following AF ablation. We sought to determine whether baseline clinical characteristics were associated with LGE extent among patients presenting for an initial AF ablation. Methods and results: The cohort consisted of 179 consecutive patients with no prior cardiac ablation procedures who underwent pre-procedure LGE-CMR. The extent of LA LGE for each patient was calculated using the image intensity ratio, normalized to the mean blood pool intensity, corresponding to a bipolar voltage ≤0.3 mV. The association of LGE extent with baseline clinical characteristics was examined using non-parametric and multivariable models. The mean age of the cohort was 60.9±9.6 years and 128 (72%) were male. In total, 56 (31%) patients had persistent AF. The mean LA volume was 118.4±41.6 mL, and the mean LA LGE extent was 14.1±10.4%. There was no association with any clinical variables with LGE extent by quartiles in the multivariable model. Extent of LGE as a continuous variable was positively, but weakly associated with LA volume in a multivariable model adjusting for age, body mass index, AF persistence, and left ventricular ejection fraction (1.5% scar/mL, P = 0.038). Conclusion: In a cohort of patients presenting for initial AF ablation, the presence of pre-ablation LA LGE extent was weakly, but positively associated with increasing LA volume.

KW - Ablation

KW - Atrial fibrillation

KW - Cardiac magnetic resonance imaging

KW - Delayed enhancement magnetic resonance

KW - Fibrosis

UR - http://www.scopus.com/inward/record.url?scp=85019719021&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019719021&partnerID=8YFLogxK

U2 - 10.1093/europace/euw019

DO - 10.1093/europace/euw019

M3 - Article

VL - 19

SP - 371

EP - 377

JO - Europace

JF - Europace

SN - 1099-5129

IS - 3

ER -