Age, atrial fibrillation, and structural heart disease are the main determinants of left atrial fibrosis detected by delayed-enhanced magnetic resonance imaging in a general cardiology population.
BACKGROUND
We studied the extent and distribution of left atrial (LA) fibrosis on delayed-enhanced (DE) MRI in a general cardiology population.


RESULTS
One hundred ninety consecutive patients referred for cardiac MRI underwent DE imaging using a free breathing method. The population comprised 60 AF patients and 130 patients without AF, including 75 with structural heart disease (SHD). DE was quantified using histogram thresholding, expressed in % of the wall. Regression analysis was performed to identify predictors of DE. Additionally, DE was registered on a template to study its distribution in subpopulations. In the total population, age, AF, and SHD were independently associated with DE. DE was increasingly observed from 11.1 ± 4.7% in patients with no SHD nor AF, 18.8 ± 7.8% in SHD and no AF history, 22.9 ± 7.8% in paroxysmal AF, to 27.8 ± 7.7% in persistent AF. Among non-AF patients, age and SHD were independently associated with DE. Among AF patients, female gender and AF persistence were independently associated with DE. DE was variably distributed but more frequently detected in the posterior wall.


CONCLUSIONS
Age, history of AF, and SHD are the most powerful predictors of atrial fibrosis, as detected by MRI, in a general cardiology population. Atrial fibrosis predominates in the posterior LA wall.
Department of cardiovascular imaging, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Hubert
H
Cochet
Department of cardiovascular imaging, CHU/Université de Bordeaux, Pessac, France.
Amaury
A
Mouries
Department of cardiovascular imaging, CHU/Université de Bordeaux, Pessac, France.
Hubert
H
Nivet
Department of cardiac pacing and electrophysiology, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Frederic
F
Sacher
Department of cardiac pacing and electrophysiology, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Nicolas
N
Derval
Department of cardiac pacing and electrophysiology, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Arnaud
A
Denis
Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Mathilde
M
Merle
INRIA Asclepios research team-INRIA Sophia Antipolis, Sophia Antipolis, France.
Jatin
J
Relan
Department of cardiac pacing and electrophysiology, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Mélèze
M
Hocini
Department of cardiac pacing and electrophysiology, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Michel
M
Haïssaguerre
Department of cardiovascular imaging, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
François
F
Laurent
Department of cardiovascular imaging, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Michel
M
Montaudon
Department of cardiac pacing and electrophysiology, CHU/Université de Bordeaux, Pessac, France.|Institut LIRYC-Equipex MUSIC, CHU/Université de Bordeaux/INSERM U1045, Pessac, France.
Pierre
P
Jaïs
D000328:Adult; D000367:Age Factors; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D005602:France / Q000453:epidemiology; D006325:Heart Atria / Q000473:pathology*; D006331:Heart Diseases / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors
atrial fibrillation; atrial remodeling; fibrosis; heart; magnetic resonance imaging