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. 2022 Feb;52(1):175-187.
doi: 10.3906/sag-2103-194. Epub 2022 Feb 22.

Evaluation of atrial fibrosis in atrial fibrillation patients with three different methods

Cem Çöteli  1 , Tuncay Hazırolan  2 , Kudret Aytemir  3 , Ahmet Gürkan Erdemir  2 , Emine Nilay Bakır  4 , Uğur Canpolat  5 , Hikmet Yorgun  3 , Ahmet Hakan Ateş  6 , Ergun Barış Kaya  3 , Zeliha Günnur Dikmen  4 , Necla Özer  3
Affiliations

Evaluation of atrial fibrosis in atrial fibrillation patients with three different methods

Cem Çöteli et al. Turk J Med Sci. 2022 Feb.

Abstract

Background: The presence of atrial fibrosis has already been known as a risk factor for atrial fibrillation (AF) development. We aimed to evaluate atrial fibrosis with previously defined three different methods, which were cardiac magnetic resonance imaging (C-MRI), echocardiographic strain imaging, and biomarkers and show the relationship between these methods in patients with AF scheduled for cryoballoon ablation.

Methods: A total of 30 patients were enrolled. Atrial T1 relaxation durations were measured using C-MRI before the procedure of atrial fibrillation catheter ablation. Fibroblast growth factor-21 (FGF-21) and fibroblast growth factor-23 (FGF-23) levels were measured at serum derived from the femoral artery (Peripheral FGF 21 and 23) and left atrium blood samples (Central FGF 21 and 23) before catheter ablation. Preprocedural transthoracic echocardiography was performed. The median follow-up duration for atrial tachyarrhythmia (ATa) recurrence was 13 (12-18 months) months.

Results: The mean ages of the study group were 55.23 ± 12.37 years, and there were 17 (56.7%) female patients in study population. There were negative correlations between post contrast T1 relaxation durations of both posterior and posterosuperior atrium, and central FGF-23 (r: - 0.561; p = 0.003; r:-0.624; p = 0.001; Posterior T1 vs. central FGF-23 levels and Posterosuperior T1 vs central FGF-23 levels, respectively). The positive correlations were observed between postcontrast posterior T1 relaxation durations and left ventricle ejection fraction (r:0.671; p = 0.001); left atrial emptying fraction (r:0.482; p = 0.013); peak atrial longitudinal strain (r:0.605; p = 0.001), and peak atrial contraction strain (r:0.604; p = 0.001). Also negative correlation was observed between postcontrast posterior T1 relaxation durations, and left atrial volume index (r: - 0.467; p = 0.016).

Keywords: Atrial fibrillation; FGF-21; FGF-23; atrial fibrosis; atrial strain imaging; cardiac MRI T1 relaxation duration.

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Figures

Figure 1
Figure 1
The flowchart of the study.
Figure 2
Figure 2
Left atrial strain evaluation. Strain curves of different left atrial walls are represented in different colors. The global strain curve of the left atrium is represented as a white dashed curve. PALS: Peak atrial longitudinal strain, the peak value of positive wave at end-systolic phase. PACS: Peak atrial contraction strain, the peak value of positive wave at atrial systolic phase.
Figure 3
Figure 3
A: Gray scale of posterior atrium. B: Gray scale of posterosuperior atrium. C: Rainbow-colored of posterior atrium. D: Rainbow-colored of posterosuperior atrium. E: Samples for T1 quantification of posterior atrium, selected in same shape and width. F: Samples for T1 quantification of posterosuperior atrium, selected in same shape and width.
Figure 4
Figure 4
Lin’s correlation graphs for postcontrast T1 relaxation durations of the posterior atrium in A and postcontrast T1 relaxation durations of the posterosuperior atrium in B.
See this image and copyright information in PMC

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