Hypertrophic Cardiomyopathy Patients With Paroxysmal Atrial Fibrillation Have a High Burden of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging.

Autor:	Sivalokanathan S; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland., Zghaib T; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland., Greenland GV; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Division of Cardiology, University of California San Francisco, San Francisco, California., Vasquez N; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland., Kudchadkar SM; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland., Kontari E; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland., Lu DY; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland., Dolores-Cerna K; Department of Statistics, Cayetano Heredia University, Lima, Peru., van der Geest RJ; Leiden University Medical Center, Leiden, the Netherlands., Kamel IR; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland., Olgin JE; Division of Cardiology, University of California San Francisco, San Francisco, California., Abraham TP; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Division of Cardiology, University of California San Francisco, San Francisco, California., Nazarian S; Division of Cardiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania., Zimmerman SL; Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland., Abraham MR; Hypertrophic Cardiomyopathy Center of Excellence, Johns Hopkins University, Baltimore, Maryland; Division of Cardiology, University of California San Francisco, San Francisco, California. Electronic address: Roselle.Abraham@ucsf.edu.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2019 Mar; Vol. 5 (3), pp. 364-375. Date of Electronic Publication: 2018 Dec 26.
DOI:	10.1016/j.jacep.2018.10.016
Abstrakt:	Objectives: This study hypothesized that paroxysmal atrial fibrillation (PAF) reflects the presence of a more severe cardiac hypertrophic cardiomyopathy (HCM) phenotype. Background: HCM is characterized by myocyte hypertrophy, fibrosis, and a high prevalence of PAF. It is currently unresolved whether atrial fibrillation (AF) is a marker or a mediator of adverse outcomes in HCM. Methods: This study retrospectively examined 45 HCM patients who underwent cardiovascular magnetic resonance (CMR) imaging in sinus rhythm. The function of all 4 cardiac chambers was assessed, as well as late gadolinium enhancement (LGE) in the left atrium (LA) and left ventricle (LV), as indicators of fibrosis. A fat-saturated, 3-dimensional inversion recovery-prepared, fast-spoiled, gradient-recalled echo sequence, and the image intensity ratio method were used to measure LA-LGE; LGE in the LV was quantified using a semi-automated threshold technique. Results: HCM patients (n = 45) were divided into 2 groups (PAF, no AF) based on history of PAF. All HCM patients had LGE in the LA posterior wall. The PAF group (n = 18) had higher LA volume, a lower LA ejection fraction, a lower global peak longitudinal LA strain (PLAS), and a higher amount of LA-LGE compared with the no AF group (n = 27). A modest inverse association was noted between the LA ejection fraction, PLAS, and LA-LGE; a positive association was present between LV-LGE and LA-LGE. The PAF group had lower ejection fractions in the LV, right atrium, and right ventricle compared with those in the no AF group. Conclusions: PAF is associated with a greater degree of structural LA remodeling and global myopathy, which suggests a more severe cardiac HCM phenotype. (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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