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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or

Gaetano Nucifora1, Joanne D Schuijf, Jacob M van Werkhoven

  • 1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.

The International Journal of Cardiovascular Imaging
|October 19, 2010
PubMed

Insights

Atrial fibrillation (AF) patients show a higher burden of coronary artery disease (CAD). However, this increased CAD does not lead to a greater risk of myocardial ischemia compared to patients without AF.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) is frequently associated with coronary artery disease (CAD).
  • The relationship between the extent of CAD and myocardial ischemia in AF patients remains unclear.
  • Investigating this link is crucial for understanding AF pathophysiology and patient management.

Purpose of the Study:

  • To determine if a higher burden of coronary artery disease (CAD) in atrial fibrillation (AF) patients correlates with an increased incidence of myocardial ischemia.
  • To compare the prevalence of obstructive CAD and myocardial ischemia between AF patients and a matched control group without AF.

Main Methods:

  • Prospective study involving 87 AF patients and 122 controls without AF history.
  • Coronary artery disease assessment using Multi-Slice Computed Tomography (MSCT) coronary angiography.
  • Myocardial ischemia evaluation via stress testing (exercise ECG or myocardial perfusion imaging).
  • Classification of CAD as obstructive (≥50% narrowing) or non-obstructive and stress tests as normal or abnormal.

Main Results:

  • A significantly higher prevalence of obstructive CAD was found in AF patients (40%) compared to controls (25%, P=0.013).
  • Myocardial ischemia, indicated by positive stress tests, was observed in 49% of AF patients with obstructive CAD and 48% of non-AF patients with obstructive CAD.
  • Despite a greater CAD burden, AF patients did not exhibit a higher rate of myocardial ischemia.

Conclusions:

  • The increased prevalence of coronary artery disease in atrial fibrillation patients is not associated with a higher burden of myocardial ischemia.
  • These findings suggest that AF itself, or other coexisting factors, may play a more significant role in AF pathophysiology than the severity of underlying CAD.
  • Further research is warranted to elucidate the complex interplay between AF, CAD, and ischemic heart disease.

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