The Incidence, Pattern, and Prognostic Value of Left Ventricular Myocardial Scar by Late Gadolinium Enhancement in Patients With Atrial Fibrillation

dc.creatorNeilan, TG
dc.creatorShah, RV
dc.creatorAbbasi, SA
dc.creatorFarhad, H
dc.creatorGroarke, JD
dc.creatorDodson, JA
dc.creatorCoelho, O
dc.creatorMcMullan, CJ
dc.creatorHeydari, B
dc.creatorMichaud, GF
dc.creatorJohn, RM
dc.creatorvan der Geest, R
dc.creatorSteigner, ML
dc.creatorBlankstein, R
dc.creatorJerosch-Herold, M
dc.creatorKwong, RY
dc.date2013
dc.dateDEC 10
dc.date2014-07-30T19:38:15Z
dc.date2015-11-26T17:51:09Z
dc.date2014-07-30T19:38:15Z
dc.date2015-11-26T17:51:09Z
dc.date.accessioned2018-03-29T00:34:31Z
dc.date.available2018-03-29T00:34:31Z
dc.identifierJournal Of The American College Of Cardiology. Elsevier Science Inc, v. 62, n. 23, n. 2205, n. 2214, 2013.
dc.identifier0735-1097
dc.identifier1558-3597
dc.identifierWOS:000328073000010
dc.identifier10.1016/j.jacc.2013.07.067
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/73449
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/73449
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1289900
dc.descriptionObjectives 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 [LR chi(2)]: 15.2; p = 0.0001), diabetes (HR: 2.39; 95% CI: 1.41 to 4.09; LR chi(2): 10.3; p = 0.001), a history of heart failure (HR: 1.78; 95% CI: 1.09 to 2.91; LR chi(2) 2: 5.37; p = 0.02), left atrial dimension (HR: 1.04; 95% CI: 1.01 to 1.08; LR chi(2) 2: 6.47; p = 0.01), presence of LGE (HR: 5.08; 95% CI: 3.08 to 8.36; LR chi(2):28.8; p < 0.0001), and LGE extent (HR: 1.15; 95% CI: 1.10 to 1.21; LR chi(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. (C) 2013 by the American College of Cardiology Foundation
dc.description62
dc.description23
dc.description2205
dc.description2214
dc.descriptionAmerican Heart Association Fellow to Faculty Grant [12FTF12060588]
dc.descriptionNIH
dc.descriptionNational Institutes of Health [RO1HL090634, RO1HL091157]
dc.descriptionAmerican Heart Association Fellow to Faculty Grant [12FTF12060588]
dc.descriptionNational Institutes of Health [RO1HL090634, RO1HL091157]
dc.languageen
dc.publisherElsevier Science Inc
dc.publisherNew York
dc.publisherEUA
dc.relationJournal Of The American College Of Cardiology
dc.relationJ. Am. Coll. Cardiol.
dc.rightsfechado
dc.rightshttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.sourceWeb of Science
dc.subjectatrial fibrillation
dc.subjectcardiac magnetic resonance late
dc.subjectgadolinium enhancement
dc.subjectCardiac Magnetic-resonance
dc.subjectRadiofrequency Catheter Ablation
dc.subjectTomography Coronary-angiography
dc.subjectOf-cardiology Foundation
dc.subjectPulmonary Vein Isolation
dc.subjectComputed-tomography
dc.subjectHypertrophic Cardiomyopathy
dc.subjectHeart-failure
dc.subjectIntracardiac Echocardiography
dc.subjectEjection Fraction
dc.titleThe Incidence, Pattern, and Prognostic Value of Left Ventricular Myocardial Scar by Late Gadolinium Enhancement in Patients With Atrial Fibrillation
dc.typeArtículos de revistas


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