心房颤动患者弥漫性左心室心肌纤维化的影像学、生物标志物和侵袭性评估。
Imaging, biomarker and invasive assessment of diffuse left ventricular myocardial fibrosis in atrial fibrillation.
机构信息
Department of Cardiology, Leeds General Infirmary, X39 Cardiology Offices, Great George St, Leeds, LS1 3EX, UK.
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
出版信息
J Cardiovasc Magn Reson. 2020 Feb 10;22(1):13. doi: 10.1186/s12968-020-0603-y.
BACKGROUND
Using cardiovascular magnetic resonance imaging (CMR), it is possible to detect diffuse fibrosis of the left ventricle (LV) in patients with atrial fibrillation (AF), which may be independently associated with recurrence of AF after ablation. By conducting CMR, clinical, electrophysiology and biomarker assessment we planned to investigate LV myocardial fibrosis in patients undergoing AF ablation.
METHODS
LV fibrosis was assessed by T1 mapping in 31 patients undergoing percutaneous ablation for AF. Galectin-3, coronary sinus type I collagen C terminal telopeptide (ICTP), and type III procollagen N terminal peptide were measured with ELISA. Comparison was made between groups above and below the median for LV extracellular volume fraction (ECV), followed by regression analysis.
RESULTS
On linear regression analysis LV ECV had significant associations with invasive left atrial pressure (Beta 0.49, P = 0.008) and coronary sinus ICTP (Beta 0.75, P < 0.001), which remained significant on multivariable regression.
CONCLUSION
LV fibrosis in patients with AF is associated with left atrial pressure and invasively measured levels of ICTP turnover biomarker.
背景
利用心血管磁共振成像（CMR），可以检测到房颤（AF）患者左心室（LV）的弥漫性纤维化，这可能与消融后 AF 的复发独立相关。通过进行 CMR、临床、电生理学和生物标志物评估，我们计划研究接受 AF 消融的患者的 LV 心肌纤维化。
方法
对 31 例行经皮消融治疗的 AF 患者进行 LV 纤维化的 T1 映射评估。通过 ELISA 测量半乳糖凝集素-3、冠状窦 I 型胶原 C 末端肽（ICTP）和 III 型前胶原 N 末端肽。比较 LV 细胞外容积分数（ECV）中位数以上和以下的组，然后进行回归分析。
结果
线性回归分析显示，LV ECV 与有创性左心房压力（Beta 0.49，P = 0.008）和冠状窦 ICTP（Beta 0.75，P < 0.001）呈显著相关，多变量回归分析结果仍然显著。
结论
AF 患者的 LV 纤维化与左心房压力和侵入性测量的 ICTP 转换生物标志物有关。
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