Premium
Noninvasive assessment of left atrial fibrosis. Correlation between echocardiography, biomarkers, and electroanatomical mapping
Author(s) -
PilichowskaPaszkiet Ewa,
Baran Jakub,
Sygitowicz Grażyna,
Sikorska Agnieszka,
Stec Sebastian,
Kułakowski Piotr,
Zaborska Beata
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14043
Subject(s) - medicine , cardiology , atrial fibrillation , sinus rhythm , speckle tracking echocardiography , fibrosis , catheter ablation , diastole , ejection fraction , heart failure , blood pressure
Aim Left atrial ( LA ) fibrosis promotes atrial fibrillation ( AF ), may predict poor radiofrequency catheter ablation ( RFCA ) outcome, and may be assessed invasively using electroanatomical mapping ( EAM ). Speckle tracking echocardiography ( STE ) enables quantitative assessment of LA function. The aim was to assess the relationship between LA fibrosis derived from EAM and LA echocardiographic parameters as well as biomarkers of fibrosis in patients with AF . Methods Sixty‐six patients (64% males, mean age 56 ± 10) with nonvalvular AF treated with first RFCA were prospectively studied. Seventy‐three percent of patients were in sinus rhythm at the time of examination. LA geometry, systolic, and diastolic function were assessed. In STE global, peak atrial longitudinal ( PALS ) and contractile ( PACS ) strain were calculated. LA stiffness index ( LA s) — the ratio of E/e′ to PALS — was assessed. The EAM of LA was build using Carto System before RFCA . Low amplitude potentials area ( LAPA ) was quantitatively analyzed and expressed as a percentage of LA surface using the cut‐off <0.5 mV to detect potential sites of fibrosis. The serum concentrations of MMP ‐9, PIIINP , and TGF β1were estimated before RFCA . Results Pearson correlation analysis showed a significant correlation between LA diastolic function parameters: PALS (−0.54, P < .001), LA s (0.65, P < .001), and LAPA in patients who were in sinus rhythm. Also LA volume significantly correlated with LAPA (0.44, P < .002). None of biomarkers correlated with LAPA . Conclusion Left atrial diastolic parameters derived from STE correlate well with the extent of LA fibrosis. Thus, STE may be useful in the noninvasive assessment of LA fibrosis and selection of candidates for RFCA .