Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation.
Aims
This study aims to examine the association of clinical co-morbidities with the presence of left atrial (LA) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). Previous studies have established the severity of LA LGE to be associated with atrial fibrillation (AF) recurrence following AF ablation. We sought to determine whether baseline clinical characteristics were associated with LGE extent among patients presenting for an initial AF ablation.


Methods and results
The cohort consisted of 179 consecutive patients with no prior cardiac ablation procedures who underwent pre-procedure LGE-CMR. The extent of LA LGE for each patient was calculated using the image intensity ratio, normalized to the mean blood pool intensity, corresponding to a bipolar voltage ≤0.3 mV. The association of LGE extent with baseline clinical characteristics was examined using non-parametric and multivariable models. The mean age of the cohort was 60.9 ± 9.6 years and 128 (72%) were male. In total, 56 (31%) patients had persistent AF. The mean LA volume was 118.4 ± 41.6 mL, and the mean LA LGE extent was 14.1 ± 10.4%. There was no association with any clinical variables with LGE extent by quartiles in the multivariable model. Extent of LGE as a continuous variable was positively, but weakly associated with LA volume in a multivariable model adjusting for age, body mass index, AF persistence, and left ventricular ejection fraction (1.5% scar/mL, P = 0.038).


Conclusion
In a cohort of patients presenting for initial AF ablation, the presence of pre-ablation LA LGE extent was weakly, but positively associated with increasing LA volume.
['Chrispin|Jonathan|J|', 'Ipek|Esra Gucuk|EG|', 'Habibi|Mohammadali|M|', 'Yang|Eunice|E|', 'Spragg|David|D|', 'Marine|Joseph E|JE|', 'Ashikaga|Hiroshi|H|', 'Rickard|John|J|', 'Berger|Ronald D|RD|', 'Zimmerman|Stefan L|SL|', 'Calkins|Hugh|H|', 'Nazarian|Saman|S|']
D000368:Aged D001281:Atrial Fibrillation D016279:Atrial Function, Left D064752:Atrial Remodeling D017115:Catheter Ablation D003287:Contrast Media D005260:Female D005355:Fibrosis D019786:Gadolinium DTPA D006325:Heart Atria D006801:Humans D016014:Linear Models D016015:Logistic Models D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D016017:Odds Ratio D011237:Predictive Value of Tests D011446:Prospective Studies D012042:Registries D012307:Risk Factors D013318:Stroke Volume D016277:Ventricular Function, Left
Atrial fibrillation Ablation Cardiac magnetic resonance imaging Delayed enhancement magnetic resonance Fibrosis