PMID- 32563642
OWN - NLM
STAT- MEDLINE
DCOM- 20210721
LR  - 20211119
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 13
IP  - 8
DP  - 2020 Aug
TI  - Left Atrial Late Gadolinium Enhancement is Associated With Incident Atrial 
      Fibrillation as Detected by Continuous Monitoring With Implantable Loop 
      Recorders.
PG  - 1690-1700
LID - S1936-878X(20)30338-7 [pii]
LID - 10.1016/j.jcmg.2020.03.024 [doi]
AB  - OBJECTIVES: The authors hypothesized that left atrial (LA) fibrosis was 
      associated with incident atrial fibrillation (AF) as detected by continuous 
      long-term monitoring in an at-risk population. BACKGROUND: LA late gadolinium 
      enhancement (LGE) measured with cardiac magnetic resonance is emerging as a 
      marker of atrial fibrosis and has been associated with worse outcomes in AF 
      ablation procedures; however, the prognostic value of LA LGE for incident AF 
      remains unknown. METHODS: Cardiac magnetic resonance, including measurement of 
      left ventricular and LA volumes and function, as well as left ventricular 
      extracellular volume fraction and LA LGE, was acquired in 68 patients aged at 
      least 70 years with risk factors for stroke. All included patients received an 
      implantable loop recorder and were continuously monitored for previously unknown 
      AF. Incident AF was adjudicated by senior cardiologists. RESULTS: Patients were 
      monitored for AF with an implantable loop recorder during a median of 41 
      (interquartile range: 7) months. AF episodes lasting >/=6 min were detected in 32 
      patients (47%), and 16 patients (24%) experienced AF episodes lasting >/=5.5 h. In 
      Cox regression analyses adjusted for sex, age, and comorbidities, we found that 
      LA volumes and function and LA LGE were independently associated with incident 
      AF. For LA LGE, the hazard ratios for time to AF episodes lasting >/=6 min 
      and >/=5.5 h were 1.40 (95% CI: 1.03 to 1.89) per 10 cm(2) increase (p = 0.03) and 
      1.63 (95% CI: 1.11 to 2.40) per 10 cm(2) increase (p = 0.01), respectively. LA 
      LGE was significantly associated with high burden of AF. The addition of LA LGE 
      to a multivariable risk prediction model for incident AF significantly increased 
      the predictive value. CONCLUSIONS: Extent of LA fibrosis measured by LA LGE was 
      significantly associated with incident AF detected by implantable loop recorder. 
      (Atrial Fibrillation Detected by Continuous ECG Monitoring [LOOP]; NCT02036450).
CI  - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Bertelsen, Litten
AU  - Bertelsen L
AD  - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 
      Copenhagen, Denmark. Electronic address: littenbertelsen@gmail.com.
FAU - Diederichsen, Soren Zoga
AU  - Diederichsen SZ
AD  - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 
      Copenhagen, Denmark.
FAU - Haugan, Ketil Jorgen
AU  - Haugan KJ
AD  - Department of Cardiology, Sjaelland University Hospital Roskilde, Roskilde, 
      Denmark.
FAU - Brandes, Axel
AU  - Brandes A
AD  - Department of Cardiology, Odense University Hospital, Odense, Denmark; Department 
      of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 
      Odense, Denmark.
FAU - Graff, Claus
AU  - Graff C
AD  - Department of Health Science and Technology, Aalborg University, Aalborg, 
      Denmark.
FAU - Krieger, Derk
AU  - Krieger D
AD  - University Hospital Zurich, University of Zurich, Switzerland; Stroke Unit, 
      Mediclinic City Hospital, Dubai, UAE.
FAU - Kronborg, Christian
AU  - Kronborg C
AD  - Department of Business and Economics, University of Southern Denmark, Odense, 
      Denmark.
FAU - Kober, Lars
AU  - Kober L
AD  - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 
      Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and 
      Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
FAU - Peters, Dana C
AU  - Peters DC
AD  - Department of Radiology and Biomedical Imaging, Yale School of Medicine, New 
      Haven, Connecticut.
FAU - Olesen, Morten Salling
AU  - Olesen MS
AD  - Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, 
      Copenhagen University Hospital, Copenhagen, Denmark; Department of Biomedical 
      Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 
      Copenhagen, Denmark.
FAU - Hojberg, Soren
AU  - Hojberg S
AD  - Department of Cardiology, Bispebjerg Hospital, Copenhagen University Hospital, 
      Copenhagen, Denmark.
FAU - Vejlstrup, Niels
AU  - Vejlstrup N
AD  - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 
      Copenhagen, Denmark.
FAU - Svendsen, Jesper Hastrup
AU  - Svendsen JH
AD  - Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, 
      Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and 
      Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Laboratory for 
      Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen 
      University Hospital, Copenhagen, Denmark.
LA  - eng
SI  - ClinicalTrials.gov/NCT02036450
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200617
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2020 Aug;13(8):1701-1703. PMID: 32682723
EIN - JACC Cardiovasc Imaging. 2021 Feb;14(2):523-524. PMID: 33541533
CIN - JACC Cardiovasc Imaging. 2021 Mar;14(3):704-705. PMID: 33663771
CIN - JACC Cardiovasc Imaging. 2021 Mar;14(3):704. PMID: 33663772
MH  - *Atrial Fibrillation/surgery
MH  - Catheter Ablation
MH  - Contrast Media
MH  - Fibrosis
MH  - Gadolinium
MH  - Heart Atria/pathology
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Predictive Value of Tests
OTO - NOTNLM
OT  - atrial fibrillation
OT  - cardiovascular magnetic resonance imaging
OT  - fibrosis
OT  - late gadolinium enhancement
OT  - left atrium
EDAT- 2020/06/22 06:00
MHDA- 2021/07/22 06:00
CRDT- 2020/06/22 06:00
PHST- 2019/11/25 00:00 [received]
PHST- 2020/03/12 00:00 [revised]
PHST- 2020/03/20 00:00 [accepted]
PHST- 2020/06/22 06:00 [pubmed]
PHST- 2021/07/22 06:00 [medline]
PHST- 2020/06/22 06:00 [entrez]
AID - S1936-878X(20)30338-7 [pii]
AID - 10.1016/j.jcmg.2020.03.024 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2020 Aug;13(8):1690-1700. doi: 
      10.1016/j.jcmg.2020.03.024. Epub 2020 Jun 17.