| Autor: |
Lacaita PG; Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria., Beyer C; Department of Cardiology, Tyrol Clinicum Hall, 6060 Hall, Austria., Plank F; Department of Cardiology, Tyrol Clinicum Hall, 6060 Hall, Austria., Stühlinger M; Department of Cardiology, Innsbruck Medical University, 6020 Innsbruck, Austria., Feuchtner GM; Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria. |
| Jazyk: |
angličtina |
| Zdroj: |
Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2024 Dec 06; Vol. 14 (23). Date of Electronic Publication: 2024 Dec 06. |
| DOI: |
10.3390/diagnostics14232753 |
| Abstrakt: |
Background/Objective : Left atrial (LA) fibrosis imaging improves the guidance of LA catheter ablation. Cardiac computed tomography (CT) may be a reasonable alternative to CMR. The aim was to evaluate late enhancement (LE) fibrosis mapping by CT, and to correlate the results with low-voltage areas on electroanatomical mapping (EAM). Methods : In patients with atrial fibrillation who underwent 128-slice dual-source CT angiography (CTA) prior to LA catheter ablation, an additional LE-CT scan was performed 7 min after CTA. (1) Left atrial wall thickness (LAWT) was measured at three sites along the LA ridge. (2) Late enhancement (LE) was quantified co-axially aligned to LAWT and compared with low-voltage areas (LVA) on EAM. Results : Of 137 patients (age: 59.8 years; 27.7% females), 108 were included. The prevalence of LE was higher in patients with LAWT > 2 mm compared with 1.5 mm, with 78 (91.7%) vs. 77 (80.2%) ( p = 0.022). Of 78 patients with LE, 60 (77.1%) had focal, 13 (16.5%) had diffuse, and 5 (6.3%) had mixed LE patterns. The CT density of focal LE was not different from that of diffuse patterns (104.2 +/- 21 HU vs. 98.9 +/- 18 HU; p = 0.360). Increasing LAWT and LE-HU were weakly correlated (r = 0.229; p = 0.041). LA wall artifacts had higher CT density compared with LE (154.1 HU vs. 114.2 HU; p = 0.002). The effective radiation dose was 0.95 mSv (range, 0.52-1.2 mSv) for LE-CT. The agreement of LE-CT was 80% for LVA < 0.5 mV and 86.6% for LVA < 0.7 mV in a subset of 30 patients. Conclusions : Left atrial fibrosis mapping by LE-CT is feasible. Late enhancement was found more frequently in LAWTs of more than 2 mm, and LE was correlated with increasing LA remodeling and low-voltage areas. |
| Databáze: |
MEDLINE |
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