Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation
Background Left atrial structural remodeling contributes to the arrhythmogenic substrate of atrial fibrillation (AF), but the role of the right atrium (RA) remains unknown. Our aims were to comprehensively characterize right atrial structural remodeling in AF and identify right atrial parameters pre...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-10-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.026028 |
| _version_ | 1827976952541085696 |
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| author | Clara Gunturiz‐Beltrán Marta Nuñez‐Garcia Till F. Althoff Roger Borràs Rosa M. Figueras i Ventura Paz Garre Gala Caixal Susanna Prat‐González Rosario J. Perea Eva Maria Benito Jose Maria Tolosana Elena Arbelo Ivo Roca‐Luque Josep Brugada Marta Sitges Lluís Mont Eduard Guasch |
| author_facet | Clara Gunturiz‐Beltrán Marta Nuñez‐Garcia Till F. Althoff Roger Borràs Rosa M. Figueras i Ventura Paz Garre Gala Caixal Susanna Prat‐González Rosario J. Perea Eva Maria Benito Jose Maria Tolosana Elena Arbelo Ivo Roca‐Luque Josep Brugada Marta Sitges Lluís Mont Eduard Guasch |
| author_sort | Clara Gunturiz‐Beltrán |
| collection | DOAJ |
| description | Background Left atrial structural remodeling contributes to the arrhythmogenic substrate of atrial fibrillation (AF), but the role of the right atrium (RA) remains unknown. Our aims were to comprehensively characterize right atrial structural remodeling in AF and identify right atrial parameters predicting recurrences after ablation. Methods and Results A 3.0 T late gadolinium enhanced–cardiac magnetic resonance was obtained in 109 individuals (9 healthy volunteers, 100 patients with AF undergoing ablation). Right and left atrial volume, surface, and sphericity were quantified. Right atrial global and regional fibrosis burden was assessed with validated thresholds. Patients with AF were systematically followed after ablation for recurrences. Progressive right atrial dilation and an increase in sphericity were observed from healthy volunteers to patients with paroxysmal and persistent AF; fibrosis was similar among the groups. The correlation between parameters recapitulating right atrial remodeling was mild. Subsequently, remodeling in both atria was compared. The RA was larger than the left atrium (LA) in all groups. Fibrosis burden was higher in the LA than in the RA of patients with AF, whereas sphericity was higher in the LA of patients with persistent AF only. Fibrosis, volume, and surface of the RA and LA, but not sphericity, were strongly correlated. Tricuspid regurgitation predicted right atrial volume and shape, whereas diabetes was associated with right atrial fibrosis burden; sex and persistent AF also predicted right atrial volume. Fibrosis in the RA was mostly located in the inferior vena cava–RA junction. Only right atrial sphericity is significantly associated with AF recurrences after ablation (hazard ratio, 1.12 [95% CI, 1.01–1.25]). Conclusions AF progression associates with right atrial remodeling in parallel with the LA. Right atrial sphericity yields prognostic significance after ablation. |
| first_indexed | 2024-04-09T20:56:45Z |
| format | Article |
| id | doaj.art-b668fcc81e57490b9b3afb534d9a4dc1 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T20:56:45Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b668fcc81e57490b9b3afb534d9a4dc12023-03-29T18:35:07ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-10-01112010.1161/JAHA.122.026028Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial FibrillationClara Gunturiz‐Beltrán0Marta Nuñez‐Garcia1Till F. Althoff2Roger Borràs3Rosa M. Figueras i Ventura4Paz Garre5Gala Caixal6Susanna Prat‐González7Rosario J. Perea8Eva Maria Benito9Jose Maria Tolosana10Elena Arbelo11Ivo Roca‐Luque12Josep Brugada13Marta Sitges14Lluís Mont15Eduard Guasch16Arrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainElectrophysiology and Heart Modeling Institute (IHU LIRYC) Pessac FranceArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainADAS 3D Medical SL Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainArrhythmia Section, Institut Clínic Cardiovascular Hospital Clínic, Universitat de Barcelona Barcelona Catalonia SpainBackground Left atrial structural remodeling contributes to the arrhythmogenic substrate of atrial fibrillation (AF), but the role of the right atrium (RA) remains unknown. Our aims were to comprehensively characterize right atrial structural remodeling in AF and identify right atrial parameters predicting recurrences after ablation. Methods and Results A 3.0 T late gadolinium enhanced–cardiac magnetic resonance was obtained in 109 individuals (9 healthy volunteers, 100 patients with AF undergoing ablation). Right and left atrial volume, surface, and sphericity were quantified. Right atrial global and regional fibrosis burden was assessed with validated thresholds. Patients with AF were systematically followed after ablation for recurrences. Progressive right atrial dilation and an increase in sphericity were observed from healthy volunteers to patients with paroxysmal and persistent AF; fibrosis was similar among the groups. The correlation between parameters recapitulating right atrial remodeling was mild. Subsequently, remodeling in both atria was compared. The RA was larger than the left atrium (LA) in all groups. Fibrosis burden was higher in the LA than in the RA of patients with AF, whereas sphericity was higher in the LA of patients with persistent AF only. Fibrosis, volume, and surface of the RA and LA, but not sphericity, were strongly correlated. Tricuspid regurgitation predicted right atrial volume and shape, whereas diabetes was associated with right atrial fibrosis burden; sex and persistent AF also predicted right atrial volume. Fibrosis in the RA was mostly located in the inferior vena cava–RA junction. Only right atrial sphericity is significantly associated with AF recurrences after ablation (hazard ratio, 1.12 [95% CI, 1.01–1.25]). Conclusions AF progression associates with right atrial remodeling in parallel with the LA. Right atrial sphericity yields prognostic significance after ablation.https://www.ahajournals.org/doi/10.1161/JAHA.122.026028atrial dilatationatrial fibrillationatrial remodelingatrial sphericitylate gadolinium‐enhanced magnetic resonanceregional fibrosis |
| spellingShingle | Clara Gunturiz‐Beltrán Marta Nuñez‐Garcia Till F. Althoff Roger Borràs Rosa M. Figueras i Ventura Paz Garre Gala Caixal Susanna Prat‐González Rosario J. Perea Eva Maria Benito Jose Maria Tolosana Elena Arbelo Ivo Roca‐Luque Josep Brugada Marta Sitges Lluís Mont Eduard Guasch Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial dilatation atrial fibrillation atrial remodeling atrial sphericity late gadolinium‐enhanced magnetic resonance regional fibrosis |
| title | Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation |
| title_full | Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation |
| title_fullStr | Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation |
| title_full_unstemmed | Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation |
| title_short | Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation |
| title_sort | progressive and simultaneous right and left atrial remodeling uncovered by a comprehensive magnetic resonance assessment in atrial fibrillation |
| topic | atrial dilatation atrial fibrillation atrial remodeling atrial sphericity late gadolinium‐enhanced magnetic resonance regional fibrosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.026028 |
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