Myocardial Extracellular Volume Expansion And The Risk Of Recurrent Atrial Fibrillation After Pulmonary Vein Isolation

dc.creatorNeilan T.G.
dc.creatorMongeon F.-P.
dc.creatorShah R.V.
dc.creatorCoelho-Filho O.
dc.creatorAbbasi S.A.
dc.creatorDodson J.A.
dc.creatorMcMullan C.J.
dc.creatorHeydari B.
dc.creatorMichaud G.F.
dc.creatorJohn R.M.
dc.creatorBlankstein R.
dc.creatorJerosch-Herold M.
dc.creatorKwong R.Y.
dc.date2014
dc.date2015-06-25T17:57:11Z
dc.date2015-11-26T14:50:11Z
dc.date2015-06-25T17:57:11Z
dc.date2015-11-26T14:50:11Z
dc.date.accessioned2018-03-28T22:01:22Z
dc.date.available2018-03-28T22:01:22Z
dc.identifier
dc.identifierJacc: Cardiovascular Imaging. , v. 7, n. 1, p. 1 - 11, 2014.
dc.identifier1936878X
dc.identifier10.1016/j.jcmg.2013.08.013
dc.identifierhttp://www.scopus.com/inward/record.url?eid=2-s2.0-84892546008&partnerID=40&md5=7fade4feef490c0ca16be0331fc4d812
dc.identifierhttp://www.repositorio.unicamp.br/handle/REPOSIP/87203
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/87203
dc.identifier2-s2.0-84892546008
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1254104
dc.descriptionObjectives This study tested whether myocardial extracellular volume (ECV) is increased in patients with hypertension and atrial fibrillation (AF) undergoing pulmonary vein isolation and whether there is an association between ECV and post-procedural recurrence of AF. Background Hypertension is associated with myocardial fibrosis, an increase in ECV, and AF. Data linking these findings are limited. T1 measurements pre-contrast and post-contrast in a cardiac magnetic resonance (CMR) study provide a method for quantification of ECV. Methods Consecutive patients with hypertension and recurrent AF referred for pulmonary vein isolation underwent a contrast CMR study with measurement of ECV and were followed up prospectively for a median of 18 months. The endpoint of interest was late recurrence of AF. Results Patients had elevated left ventricular (LV) volumes, LV mass, left atrial volumes, and increased ECV (patients with AF, 0.34 ± 0.03; healthy control patients, 0.29 ± 0.03; p < 0.001). There were positive associations between ECV and left atrial volume (r = 0.46, p < 0.01) and LV mass and a negative association between ECV and diastolic function (early mitral annular relaxation [E′], r = -0.55, p < 0.001). In the best overall multivariable model, ECV was the strongest predictor of the primary outcome of recurrent AF (hazard ratio: 1.29; 95% confidence interval: 1.15 to 1.44; p < 0.0001) and the secondary composite outcome of recurrent AF, heart failure admission, and death (hazard ratio: 1.35; 95% confidence interval: 1.21 to 1.51; p < 0.0001). Each 10% increase in ECV was associated with a 29% increased risk of recurrent AF. Conclusions In patients with AF and hypertension, expansion of ECV is associated with diastolic function and left atrial remodeling and is a strong independent predictor of recurrent AF post-pulmonary vein isolation. © 2014 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY ELSEVIER INC.
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dc.languageen
dc.publisher
dc.relationJACC: Cardiovascular Imaging
dc.rightsfechado
dc.sourceScopus
dc.titleMyocardial Extracellular Volume Expansion And The Risk Of Recurrent Atrial Fibrillation After Pulmonary Vein Isolation
dc.typeArtículos de revistas


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