Altered Left Atrial 4D Flow Characteristics In Patients With Paroxysmal Atrial Fibrillation In The Absence Of Apparent Remodeling
| Autor: | Rob J. van der Geest, Luuk H. G. A. Hopman, Marco J.W. Götte, Ahmet Demirkiran, Mark J. Mulder, Mark B. M. Hofman, Albert C. van Rossum, Peter M. van de Ven, Raquel P Amier, Lourens F. H. J. Robbers, Cornelis P Allaart, Robin Nijveldt |
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| Přispěvatelé: | Cardiology, ACS - Heart failure & arrhythmias, Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, APH - Methodology, ACS - Microcirculation |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Paroxysmal atrial fibrillation Science Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Arrhythmias 030204 cardiovascular system & hematology Article 030218 nuclear medicine & medical imaging Electrocardiography 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Left atrial Thromboembolism Internal medicine Atrial Fibrillation Image Interpretation Computer-Assisted Image Processing Computer-Assisted medicine Humans Sinus rhythm In patient Heart Atria Thrombus Observer Variation Multidisciplinary medicine.diagnostic_test Cardiac cycle business.industry Hemodynamics Disease Management Magnetic resonance imaging Atrial Remodeling medicine.disease Magnetic Resonance Imaging Pathophysiology Cardiology Medicine Disease Susceptibility business Blood Flow Velocity |
| Zdroj: | Scientific Reports, 11 Scientific Reports, 11(1):5965. Nature Publishing Group Scientific Reports, 11, 1 Demirkiran, A, Amier, R P, Hofman, M B M, van der Geest, R J, Robbers, L F H J, Hopman, L H G A, Mulder, M J, van de Ven, P, Allaart, C P, van Rossum, A C, Götte, M J W & Nijveldt, R 2021, ' Altered left atrial 4D flow characteristics in patients with paroxysmal atrial fibrillation in the absence of apparent remodeling ', Scientific Reports, vol. 11, no. 1, 5965 . https://doi.org/10.1038/s41598-021-85176-8 Scientific Reports Scientific Reports, 11(1). NATURE PORTFOLIO Scientific Reports, Vol 11, Iss 1, Pp 1-11 (2021) |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-021-85176-8 |
| Popis: | The pathophysiology behind thrombus formation in paroxysmal atrial fibrillation (AF) patients is very complex. This can be due to left atrial (LA) flow changes, remodeling, or both. We investigated differences for cardiovascular magnetic resonance (CMR)-derived LA 4D flow and remodeling characteristics between paroxysmal AF patients and patients without cardiac disease. In this proof-of-concept study, the 4D flow data were acquired in 10 patients with paroxysmal AF (age = 61 ± 8 years) and 5 age/gender matched controls (age = 56 ± 1 years) during sinus rhythm. The following LA and LA appendage flow parameters were obtained: flow velocity (mean, peak), stasis defined as the relative volume with velocities p = 0.01) and (19.3 ± 4.7 cm/s vs. 26.8 ± 5.5 cm/s, p = 0.02), respectively]. Moreover, paroxysmal AF patients expressed more stasis of blood than controls both in the LA (43.2 ± 10.8% vs. 27.8 ± 7.9%, p = 0.01) and in the LA appendage (73.3 ± 5.7% vs. 52.8 ± 16.2%, p = 0.04). With respect to energetics, paroxysmal AF patients demonstrated lower mean and peak KE values (indexed to maximum LA volume) than controls. No significant differences were observed for LA volume, function, and strain parameters between the groups. Global LA flow dynamics in paroxysmal AF patients appear to be impaired including mean/peak flow velocity, stasis fraction, and KE, partly independent of LA remodeling. This pathophysiological flow pattern may be of clinical value to explain the increased incidence of thromboembolic events in paroxysmal AF patients, in the absence of actual AF or LA remodeling. |
| Databáze: | OpenAIRE |
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