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...

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Autores: Gunturiz Beltrán, Clara, Nuñez Garcia, Marta, Althoff, Till F., Borràs, Roger, Figueras i Ventura, Rosa M., Garre, Paz, Caixal Vila, Gala, Prat González, Susanna, Perea Palazón, Rosario Jesús, Benito, Eva, Tolosana, José M. (José María), Arbelo, Elena, Roca Luque, Ivo, Brugada Terradellas, Josep, 1958-, Sitges Carreño, Marta, Mont Girbau, Lluís, Guasch i Casany, Eduard
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2022
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositório:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/199600
Acesso em linha:https://hdl.handle.net/2445/199600
Access Level:Acceso aberto
Palavra-chave:Fibril·lació auricular
Espectroscòpia
Atrial fibrillation
Spectrum analysis
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spelling Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial FibrillationGunturiz Beltrán, ClaraNuñez Garcia, MartaAlthoff, Till F.Borràs, RogerFigueras i Ventura, Rosa M.Garre, PazCaixal Vila, GalaPrat González, SusannaPerea Palazón, Rosario JesúsBenito, EvaTolosana, José M. (José María)Arbelo, ElenaRoca Luque, IvoBrugada Terradellas, Josep, 1958-Sitges Carreño, MartaMont Girbau, LluísGuasch i Casany, EduardFibril·lació auricularEspectroscòpiaAtrial fibrillationSpectrum analysisBackground 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.American Heart Association2023202320222023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion23 p.application/pdfhttps://hdl.handle.net/2445/199600Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1161/JAHA.122.026028Journal Of The American Heart Association, 2022, vol. 11, num. 20https://doi.org/10.1161/JAHA.122.026028cc by-nc-nd (c) Gunturiz Beltrán, Clara et al, 2022http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1996002026-05-29T05:05:01Z
dc.title.none.fl_str_mv Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation
title Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation
spellingShingle Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation
Gunturiz Beltrán, Clara
Fibril·lació auricular
Espectroscòpia
Atrial fibrillation
Spectrum analysis
title_short 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_sort Progressive and Simultaneous Right and Left Atrial Remodeling Uncovered by a Comprehensive Magnetic Resonance Assessment in Atrial Fibrillation
dc.creator.none.fl_str_mv Gunturiz Beltrán, Clara
Nuñez Garcia, Marta
Althoff, Till F.
Borràs, Roger
Figueras i Ventura, Rosa M.
Garre, Paz
Caixal Vila, Gala
Prat González, Susanna
Perea Palazón, Rosario Jesús
Benito, Eva
Tolosana, José M. (José María)
Arbelo, Elena
Roca Luque, Ivo
Brugada Terradellas, Josep, 1958-
Sitges Carreño, Marta
Mont Girbau, Lluís
Guasch i Casany, Eduard
author Gunturiz Beltrán, Clara
author_facet Gunturiz Beltrán, Clara
Nuñez Garcia, Marta
Althoff, Till F.
Borràs, Roger
Figueras i Ventura, Rosa M.
Garre, Paz
Caixal Vila, Gala
Prat González, Susanna
Perea Palazón, Rosario Jesús
Benito, Eva
Tolosana, José M. (José María)
Arbelo, Elena
Roca Luque, Ivo
Brugada Terradellas, Josep, 1958-
Sitges Carreño, Marta
Mont Girbau, Lluís
Guasch i Casany, Eduard
author_role author
author2 Nuñez Garcia, Marta
Althoff, Till F.
Borràs, Roger
Figueras i Ventura, Rosa M.
Garre, Paz
Caixal Vila, Gala
Prat González, Susanna
Perea Palazón, Rosario Jesús
Benito, Eva
Tolosana, José M. (José María)
Arbelo, Elena
Roca Luque, Ivo
Brugada Terradellas, Josep, 1958-
Sitges Carreño, Marta
Mont Girbau, Lluís
Guasch i Casany, Eduard
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Fibril·lació auricular
Espectroscòpia
Atrial fibrillation
Spectrum analysis
topic Fibril·lació auricular
Espectroscòpia
Atrial fibrillation
Spectrum analysis
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.
publishDate 2022
dc.date.none.fl_str_mv 2022
2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/199600
url https://hdl.handle.net/2445/199600
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1161/JAHA.122.026028
Journal Of The American Heart Association, 2022, vol. 11, num. 20
https://doi.org/10.1161/JAHA.122.026028
dc.rights.none.fl_str_mv cc by-nc-nd (c) Gunturiz Beltrán, Clara et al, 2022
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Gunturiz Beltrán, Clara et al, 2022
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 23 p.
application/pdf
dc.publisher.none.fl_str_mv American Heart Association
publisher.none.fl_str_mv American Heart Association
dc.source.none.fl_str_mv Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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