Extracellular volume fraction by T1 mapping predicts improvement of left ventricular ejection fraction after catheter ablation in patients with non-ischemic ... View Full Text


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Article Info

DATE

2021-03-16

AUTHORS

Mai Azuma, Shingo Kato, Ryusuke Sekii, Sho Kodama, Kei Kinoshita, Keisuke Suzurikawa, Minako Kagimoto, Naoki Nakayama, Kohei Iguchi, Kazuki Fukui, Tae Iwasawa, Daisuke Utsunomiya, Kazuo Kimura, Kouichi Tamura

ABSTRACT

Absence of myocardial fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI) is associated with improvement of left ventricular systolic function after catheter ablation (CA) for atrial fibrillation (AF) with non-ischemic dilated cardiomyopathy (NIDCM). Extracellular volume fraction (ECV) by T1 mapping has emerges as a non-invasive mean to quantify severity of myocardial fibrosis. The aim of this study was to assess the incremental value of ECV over LGE-MRI for the improvement of LVEF(∆EF) after CA in NIDCM patients. A total of thirty-two patients with NIDCM and AF (mean age 67.4 ± 9.3 years; 29 (91%) male) were retrospectively studied. Using a 1.5 T MR scanner and 32 channel cardiac coils, LGE-MRI, pre- and post-T1 mapping images of LV wall at mid-ventricular level (modified look-locker inversion recovery sequence) were acquired. All patients successfully underwent CA for AF, and the improvement of LVEF after CA were evaluated by echocardiography. All patients restored sinus rhythm after CA at the time of echocardiography. The mean LVEF was 35.1 ± 9.7% before CA and 52.2 ± 10.2% after CA (p < 0.001), resulting an increase of 17.4 ± 12.6%. Significant correlation was found between ∆LVEF and % LGE (r = − 0.49, p = 0.004), ∆LVEF and extracellular volume fraction (ECV) (r = − 0.47, p = 0.010). Area under the receiver operating characteristics curve (AUC) of combination of %LGE and ECV for predicting improvement of LVEF > 10% was substantially higher than that of %LGE alone (AUC: 0.830 vs 0.602). In NIDCM patients with AF, ECV had incremental value over %LGE for predicting improvement of EF by CA, suggesting that the assessment of diffuse interstitial fibrosis may be important to forecast the response of CA. More... »

PAGES

2535-2543

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10554-021-02219-x

DOI

http://dx.doi.org/10.1007/s10554-021-02219-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1136447511

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33725266


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24 schema:description Absence of myocardial fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI) is associated with improvement of left ventricular systolic function after catheter ablation (CA) for atrial fibrillation (AF) with non-ischemic dilated cardiomyopathy (NIDCM). Extracellular volume fraction (ECV) by T1 mapping has emerges as a non-invasive mean to quantify severity of myocardial fibrosis. The aim of this study was to assess the incremental value of ECV over LGE-MRI for the improvement of LVEF(∆EF) after CA in NIDCM patients. A total of thirty-two patients with NIDCM and AF (mean age 67.4 ± 9.3 years; 29 (91%) male) were retrospectively studied. Using a 1.5 T MR scanner and 32 channel cardiac coils, LGE-MRI, pre- and post-T1 mapping images of LV wall at mid-ventricular level (modified look-locker inversion recovery sequence) were acquired. All patients successfully underwent CA for AF, and the improvement of LVEF after CA were evaluated by echocardiography. All patients restored sinus rhythm after CA at the time of echocardiography. The mean LVEF was 35.1 ± 9.7% before CA and 52.2 ± 10.2% after CA (p < 0.001), resulting an increase of 17.4 ± 12.6%. Significant correlation was found between ∆LVEF and % LGE (r = − 0.49, p = 0.004), ∆LVEF and extracellular volume fraction (ECV) (r = − 0.47, p = 0.010). Area under the receiver operating characteristics curve (AUC) of combination of %LGE and ECV for predicting improvement of LVEF > 10% was substantially higher than that of %LGE alone (AUC: 0.830 vs 0.602). In NIDCM patients with AF, ECV had incremental value over %LGE for predicting improvement of EF by CA, suggesting that the assessment of diffuse interstitial fibrosis may be important to forecast the response of CA.
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30 schema:keywords EF
31 LGE
32 LGE-MRI
33 LV wall
34 LVEF
35 MR scanner
36 NIDCM
37 NIDCM patients
38 T MR scanner
39 T1 mapping
40 ablation
41 absence
42 aim
43 area
44 assessment
45 atrial fibrillation
46 cardiac coil
47 catheter ablation
48 channel cardiac coils
49 characteristic curve
50 coil
51 combination
52 correlation
53 curves
54 diffuse interstitial fibrosis
55 echocardiography
56 ejection fraction
57 emerge
58 extracellular volume fraction
59 fibrillation
60 fibrosis
61 fraction
62 function
63 gadolinium
64 images
65 imaging
66 improvement
67 improvement of EF
68 improvement of LVEF
69 increase
70 incremental value
71 interstitial fibrosis
72 late gadolinium
73 left ventricular ejection fraction
74 left ventricular systolic function
75 levels
76 magnetic resonance imaging
77 mapping
78 mapping images
79 mean LVEF
80 means
81 mid-ventricular level
82 myocardial fibrosis
83 non-invasive means
84 patients
85 receiver
86 resonance imaging
87 response
88 rhythm
89 scanner
90 severity
91 significant correlation
92 sinus rhythm
93 study
94 systolic function
95 time
96 time of echocardiography
97 total
98 values
99 ventricular ejection fraction
100 ventricular systolic function
101 volume fraction
102 wall
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