PMID- 30994724
OWN - NLM
STAT- MEDLINE
DCOM- 20200218
LR  - 20200309
IS  - 1678-4170 (Electronic)
IS  - 0066-782X (Print)
IS  - 0066-782X (Linking)
VI  - 112
IP  - 4
DP  - 2019 Apr
TI  - Intra-Atrial Dyssynchrony Using Cardiac Magnetic Resonance to Quantify Tissue 
      Remodeling in Patients with Atrial Fibrillation.
PG  - 441-450
LID - S0066-782X2019000400441 [pii]
LID - 10.5935/abc.20190064 [doi]
AB  - BACKGROUND: Recent studies suggest that left atrial (LA) late gadolinium 
      enhancement (LGE) can quantify the underlying tissue remodeling that harbors 
      atrial fibrillation (AF). However, quantification of LA-LGE requires 
      labor-intensive magnetic resonance imaging acquisition and postprocessing at 
      experienced centers. LA intra-atrial dyssynchrony assessment is an emerging 
      imaging technique that predicts AF recurrence after catheter ablation. We 
      hypothesized that 1) LA intra-atrial dyssynchrony is associated with LA-LGE in 
      patients with AF and 2) LA intra-atrial dyssynchrony is greater in patients with 
      persistent AF than in those with paroxysmal AF. METHOD: We conducted a 
      cross-sectional study comparing LA intra-atrial dyssynchrony and LA-LGE in 146 
      patients with a history of AF (60.0 +/- 10.0 years, 30.1% nonparoxysmal AF) who 
      underwent pre-AF ablation cardiac magnetic resonance (CMR) in sinus rhythm. Using 
      tissue-tracking CMR, we measured the LA longitudinal strain in two- and 
      four-chamber views. We defined intra-atrial dyssynchrony as the standard 
      deviation (SD) of the time to peak longitudinal strain (SD-TPS, in %) and the SD 
      of the time to the peak pre-atrial contraction strain corrected by the cycle 
      length (SD-TPSpreA, in %). We used the image intensity ratio (IIR) to quantify 
      LA-LGE. RESULTS: Intra-atrial dyssynchrony analysis took 5 +/- 9 minutes per case. 
      Multivariable analysis showed that LA intra-atrial dyssynchrony was independently 
      associated with LA-LGE. In addition, LA intra-atrial dyssynchrony was 
      significantly greater in patients with persistent AF than those with paroxysmal 
      AF. In contrast, there was no significant difference in LA-LGE between patients 
      with persistent and paroxysmal AF. LA intra-atrial dyssynchrony showed excellent 
      reproducibility and its analysis was less time-consuming (5 +/- 9 minutes) than the 
      LA-LGE (60 +/- 20 minutes). CONCLUSION: LA Intra-atrial dyssynchrony is a quick and 
      reproducible index that is independently associated with LA-LGE to reflect the 
      underlying tissue remodeling.
FAU - Ciuffo, Luisa Allen
AU  - Ciuffo LA
AUID- ORCID: 0000-0002-3859-1833
AD  - University of New Mexico, New Mexico - USA.
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Lima, Joao
AU  - Lima J
AD  - Johns Hopkins Hospital and Health System, Baltimore - USA.
FAU - Vasconcellos, Henrique Doria de
AU  - Vasconcellos HD
AUID- ORCID: 0000-0002-9758-2240
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Balouch, Muhammad
AU  - Balouch M
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Tao, Susumu
AU  - Tao S
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Nazarian, Saman
AU  - Nazarian S
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Spragg, David D
AU  - Spragg DD
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Marine, Joseph E
AU  - Marine JE
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Berger, Ronald D
AU  - Berger RD
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Calkins, Hugh
AU  - Calkins H
AD  - The Johns Hopkins University, Baltimore - USA.
FAU - Ashikaga, Hiroshi
AU  - Ashikaga H
AD  - The Johns Hopkins University, Baltimore - USA.
LA  - eng
LA  - por
PT  - Journal Article
DEP - 20190415
PL  - Brazil
TA  - Arq Bras Cardiol
JT  - Arquivos brasileiros de cardiologia
JID - 0421031
SB  - IM
CIN - Arq Bras Cardiol. 2019 Apr;112(4):451-452. PMID: 30994725
MH  - Aged
MH  - Atrial Fibrillation/*diagnostic imaging/*physiopathology/therapy
MH  - Atrial Remodeling/*physiology
MH  - Catheter Ablation/methods
MH  - Cross-Sectional Studies
MH  - Echocardiography/methods
MH  - Electrocardiography/methods
MH  - Female
MH  - Heart Atria/diagnostic imaging/physiopathology
MH  - Humans
MH  - Linear Models
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Stroke Volume/physiology
MH  - Time Factors
PMC - PMC6459423
COIS- Potential Conflict of Interest No potential conflict of interest relevant to this 
      article was reported.
EDAT- 2019/04/18 06:00
MHDA- 2020/02/19 06:00
PMCR- 2019/04/01
CRDT- 2019/04/18 06:00
PHST- 2018/10/21 00:00 [received]
PHST- 2019/01/21 00:00 [accepted]
PHST- 2019/04/18 06:00 [entrez]
PHST- 2019/04/18 06:00 [pubmed]
PHST- 2020/02/19 06:00 [medline]
PHST- 2019/04/01 00:00 [pmc-release]
AID - S0066-782X2019000400441 [pii]
AID - 10.5935/abc.20190064 [doi]
PST - ppublish
SO  - Arq Bras Cardiol. 2019 Apr;112(4):441-450. doi: 10.5935/abc.20190064. Epub 2019 
      Apr 15.