title: Left ventricular native T1 time and the risk of atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Native T1 mapping has emerged as a noninvasive non-contrast magnetic resonance imaging (MRI) method to assess for diffuse myocardial fibrosis. However, LV native T1 time in AF patients and its clinical relevance are unclear.
  
  
  METHODS
  Fifty paroxysmal AF patients referred for PVI (60 ± 8 years, 37 male) and 11 healthy control subjects (57 ± 8 years, 10 male) were studied. All patients were in sinus rhythm during the MRI scan. Native T1 mapping images were acquired using a Modified Look-Locker imaging (MOLLI) sequence in 3 short-axis planes (basal, mid and apical slices) using an electrocardiogram triggered single-shot acquisition with a balanced steady-state free precession readout. Late gadolinium enhanced (LGE) MRI was acquired to evaluate for LV myocardial scar.
  
  
  RESULTS
  LV ejection fraction was similar between groups (AF: 61 ± 6%; controls: 60 ± 6%, p=0.75). No LV myocardial scar was observed in any patient on LGE. Myocardial native T1 time was greater in AF patients (1099 ± 52 vs 1042 ± 20 msec, p<0.001). During a median follow-up period of 326 days, 18 of 50 (36%) patients experienced recurrence of AF. Multivariate Cox proportional hazard analysis identified elevated native T1 time as an independent predictor of recurrence of AF (HR: 6.53, 95% CI: 1.25-34.3, p=0.026).
  
  
  CONCLUSIONS
  There are differences in the native LV myocardial T1 time between AF patients with preserved LV function referred for PVI and normal controls. Native T1 time is an independent predictor of recurrence of AF after PVI in patients with paroxysmal AF.
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Cardiology, Yokohama City University, Yokohama, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Murilo
authors.initials: M
authors.lastname: Foppa
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Roujol
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Tamer
authors.initials: T
authors.lastname: Basha
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Berg
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Kraig V
authors.initials: KV
authors.lastname: Kissinger
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Goddu
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. Electronic address: rnezafat@bidmc.harvard.edu.
authors.forename: Reza
authors.initials: R
authors.lastname: Nezafat
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D016277:Ventricular Function, Left / Q000502:physiology
keywords: Atrial fibrillation; Cardiomyopathy; Fibrosis; Magnetic resonance imaging; Recurrence of atrial fibrillation; T(1) mapping