title: Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation.
abstract: OBJECTIVE
  This study aims to examine the association of clinical co-morbidities with the presence of left atrial (LA) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR). Previous studies have established the severity of LA LGE to be associated with atrial fibrillation (AF) recurrence following AF ablation. We sought to determine whether baseline clinical characteristics were associated with LGE extent among patients presenting for an initial AF ablation.
  
  
  RESULTS
  The cohort consisted of 179 consecutive patients with no prior cardiac ablation procedures who underwent pre-procedure LGE-CMR. The extent of LA LGE for each patient was calculated using the image intensity ratio, normalized to the mean blood pool intensity, corresponding to a bipolar voltage ≤0.3 mV. The association of LGE extent with baseline clinical characteristics was examined using non-parametric and multivariable models. The mean age of the cohort was 60.9 ± 9.6 years and 128 (72%) were male. In total, 56 (31%) patients had persistent AF. The mean LA volume was 118.4 ± 41.6 mL, and the mean LA LGE extent was 14.1 ± 10.4%. There was no association with any clinical variables with LGE extent by quartiles in the multivariable model. Extent of LGE as a continuous variable was positively, but weakly associated with LA volume in a multivariable model adjusting for age, body mass index, AF persistence, and left ventricular ejection fraction (1.5% scar/mL, P = 0.038).
  
  
  CONCLUSIONS
  In a cohort of patients presenting for initial AF ablation, the presence of pre-ablation LA LGE extent was weakly, but positively associated with increasing LA volume.
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chrispin
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: Esra Gucuk
authors.initials: EG
authors.lastname: Ipek
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: Mohammadali
authors.initials: M
authors.lastname: Habibi
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: Eunice
authors.initials: E
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: David
authors.initials: D
authors.lastname: Spragg
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Marine
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.|Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ashikaga
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: John
authors.initials: J
authors.lastname: Rickard
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.|Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Berger
authors.affiliation: Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Stefan L
authors.initials: SL
authors.lastname: Zimmerman
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.affiliation: Department of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.|Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Saman
authors.initials: S
authors.lastname: Nazarian
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D017115:Catheter Ablation; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005355:Fibrosis; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Ablation; Atrial fibrillation; Cardiac magnetic resonance imaging; Delayed enhancement magnetic resonance; Fibrosis