Kagimoto Minako, Kato Shingo, Takizawa Ryouya, Kodama Sho, Suzurikawa Keisuke, Azuma Mai, Nakayama Naoki, Iguchi Kohei, Fukui Kazuki, Ito Masanori, Iwasawa Tae, Kino Tabito, Utsunomiya Daisuke
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama 234-0054, Japan.
Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
J Clin Med. 2024 Dec 3;13(23):7357. doi: 10.3390/jcm13237357.
: This study investigated the relationship between LA (LA) enhancement on three-dimensional (3D) late gadolinium enhancement (LGE) MRI and recurrence after catheter ablation in patients with AF (AF). : A total of one hundred patients with AF (mean age: 68 ± 9 years, 50% with paroxysmal AF) were included in this study. Each patient underwent a high-resolution 3D LGE MRI prior to catheter ablation, allowing for detailed imaging of the LA wall. Quantitative analysis of the enhancement was performed using dedicated software designed for volumetric measurements of LA LGE. Recurrence of AF was monitored over a 90-day period following the ablation procedure. The primary outcome was the correlation between the volume of LGE in the LA and the recurrence of AF. : Multivariate analysis confirmed that the volume of LA LGE, defined as the volume exceeding 1SD above the mean signal intensity of the LA, was an independent predictor of recurrence [hazard ratio: 1.16 (95%CI: 1.04-1.29, = 0.0057)]. The area under the curve for recurrence prediction using 3D LGE MRI was 0.74 (95%CI: 0.63-0.86), with an optimal threshold of 11.72 mL, providing a sensitivity of 55% (95%CI: 32-77%) and a specificity of 86% (95%CI: 77-93%). : LA enhancement assessed by high-resolution LGE MRI may serve as a valuable imaging marker for predicting the recurrence in patients with AF following catheter ablation.
本研究调查了房颤(AF)患者三维(3D)延迟钆增强(LGE)磁共振成像(MRI)上左心房(LA)强化与导管消融术后复发之间的关系。本研究共纳入100例房颤患者(平均年龄:68±9岁,50%为阵发性房颤)。每位患者在导管消融术前均接受了高分辨率3D LGE MRI检查,以对左心房壁进行详细成像。使用专为测量左心房LGE容积设计的专用软件对强化进行定量分析。在消融术后90天内监测房颤复发情况。主要结局是左心房LGE容积与房颤复发之间的相关性。多变量分析证实,左心房LGE容积(定义为超过左心房平均信号强度1个标准差以上的容积)是复发的独立预测因素[风险比:1.16(95%置信区间:1.04 - 1.29,P = 0.0057)]。使用3D LGE MRI进行复发预测的曲线下面积为0.74(95%置信区间:0.63 - 0.86),最佳阈值为11.72 mL,灵敏度为55%(95%置信区间:32 - 77%),特异性为86%(95%置信区间:77 - 93%)。通过高分辨率LGE MRI评估的左心房强化可能是预测房颤患者导管消融术后复发的有价值的影像学标志物。