PMID- 23994399
OWN - NLM
STAT- MEDLINE
DCOM- 20140217
LR  - 20211021
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 62
IP  - 23
DP  - 2013 Dec 10
TI  - The incidence, pattern, and prognostic value of left ventricular myocardial scar 
      by late gadolinium enhancement in patients with atrial fibrillation .
PG  - 2205-14
LID - S0735-1097(13)03878-3 [pii]
LID - 10.1016/j.jacc.2013.07.067 [doi]
AB  - OBJECTIVES: This study sought to identify the frequency, pattern, and prognostic 
      significance of left ventricular (LV) late gadolinium enhancement (LGE) in 
      patients with atrial fibrillation (AF). BACKGROUND: There are limited data on the 
      presence, pattern, and prognostic significance of LV myocardial fibrosis in 
      patients with AF. LGE during cardiac magnetic resonance imaging is a marker for 
      myocardial fibrosis. METHODS: A group of 664 consecutive patients without known 
      prior myocardial infarction who were referred for radiofrequency ablation of AF 
      were studied. Cardiac magnetic resonance imaging was requested to assess 
      pulmonary venous anatomy. RESULTS: Overall, 73% were men, with a mean age of 56 
      years and a mean LV ejection fraction of 56 +/- 10%. LV LGE was found in 88 
      patients (13%). The endpoint was all-cause mortality, and in this cohort, 68 
      deaths were observed over a median follow-up period of 42 months. On univariate 
      analysis, age (hazard ratio [HR]: 1.05; 95% confidence interval [CI]: 1.03 to 
      1.08; chi-square likelihood ratio [LRchi(2)]: 15.2; p = 0.0001), diabetes (HR: 
      2.39; 95% CI: 1.41 to 4.09; LRchi(2): 10.3; p = 0.001), a history of heart failure 
      (HR: 1.78; 95% CI: 1.09 to 2.91; LRchi(2): 5.37; p = 0.02), left atrial dimension 
      (HR: 1.04; 95% CI: 1.01 to 1.08; LRchi(2): 6.47; p = 0.01), presence of LGE (HR: 
      5.08; 95% CI: 3.08 to 8.36; LRchi(2): 28.8; p < 0.0001), and LGE extent (HR: 1.15; 
      95% CI: 1.10 to 1.21; LRchi(2): 35.6; p < 0.0001) provided the strongest 
      associations with mortality. The mortality rate was 8.1% per patient-year in 
      patients with LGE compared with 2.3% patients without LGE. In the best overall 
      multivariate model for mortality, age and the extent of LGE were independent 
      predictors of mortality. Indeed, each 1% increase in the extent of LGE was 
      associated with a 15% increased risk for death. CONCLUSIONS: In patients with AF, 
      LV LGE is a frequent finding and is a powerful predictor of mortality.
CI  - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Neilan, Tomas G
AU  - Neilan TG
AD  - Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts; 
      Division of Cardiology, Department of Medicine, Massachusetts General Hospital, 
      Boston, Massachusetts; Cardiac MR PET CT Program, Department of Radiology, 
      Massachusetts General Hospital, Boston, Massachusetts.
FAU - Shah, Ravi V
AU  - Shah RV
FAU - Abbasi, Siddique A
AU  - Abbasi SA
FAU - Farhad, Hoshang
AU  - Farhad H
FAU - Groarke, John D
AU  - Groarke JD
FAU - Dodson, John A
AU  - Dodson JA
FAU - Coelho-Filho, Otavio
AU  - Coelho-Filho O
FAU - McMullan, Ciaran J
AU  - McMullan CJ
FAU - Heydari, Bobak
AU  - Heydari B
FAU - Michaud, Gregory F
AU  - Michaud GF
FAU - John, Roy M
AU  - John RM
FAU - van der Geest, Rob
AU  - van der Geest R
FAU - Steigner, Michael L
AU  - Steigner ML
FAU - Blankstein, Ron
AU  - Blankstein R
FAU - Jerosch-Herold, Michael
AU  - Jerosch-Herold M
FAU - Kwong, Raymond Y
AU  - Kwong RY
LA  - eng
GR  - R01 HL090634/HL/NHLBI NIH HHS/United States
GR  - R01 HL091157/HL/NHLBI NIH HHS/United States
GR  - T32 HL094301/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20130828
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - J Am Coll Cardiol. 2013 Dec 10;62(23):2215-6. PMID: 23994413
CIN - J Am Coll Cardiol. 2014 May 20;63(19):2055. PMID: 24561137
CIN - J Am Coll Cardiol. 2014 May 20;63(19):2055. PMID: 24561138
MH  - Adult
MH  - Aged
MH  - Atrial Fibrillation/*complications/epidemiology/pathology/surgery
MH  - Catheter Ablation
MH  - Cicatrix/*diagnosis/*epidemiology/mortality
MH  - *Contrast Media
MH  - Female
MH  - *Gadolinium
MH  - Heart Ventricles/*pathology/physiopathology
MH  - Humans
MH  - Incidence
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications
MH  - Odds Ratio
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Factors
PMC - PMC3908872
MID - NIHMS538793
OTO - NOTNLM
OT  - AF
OT  - CI
OT  - CMR
OT  - CT
OT  - ECG
OT  - EF
OT  - HR
OT  - LGE
OT  - LRchi(2)
OT  - LV
OT  - MI
OT  - atrial fibrillation
OT  - cardiac magnetic resonance
OT  - chi-square likelihood ratio
OT  - computed tomography
OT  - confidence interval
OT  - ejection fraction
OT  - electrocardiography
OT  - hazard ratio
OT  - late gadolinium enhancement
OT  - late gadolinium enhancement
OT  - left ventricular
OT  - myocardial infarction
COIS- Conflict of Interest: The Authors report that they have no relationships relevant 
      to the contents of this manuscript to disclose.
EDAT- 2013/09/03 06:00
MHDA- 2014/02/18 06:00
PMCR- 2014/12/10
CRDT- 2013/09/03 06:00
PHST- 2013/05/06 00:00 [received]
PHST- 2013/06/21 00:00 [revised]
PHST- 2013/07/08 00:00 [accepted]
PHST- 2013/09/03 06:00 [entrez]
PHST- 2013/09/03 06:00 [pubmed]
PHST- 2014/02/18 06:00 [medline]
PHST- 2014/12/10 00:00 [pmc-release]
AID - S0735-1097(13)03878-3 [pii]
AID - 10.1016/j.jacc.2013.07.067 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2013 Dec 10;62(23):2205-14. doi: 10.1016/j.jacc.2013.07.067. 
      Epub 2013 Aug 28.