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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Atrial Lesion and Diastolic Dysfunction May Be Associated With Atrial Fibrillation in Patients With Cardiac

Kaishi Otsuka1, Hiroaki Kawano1, Hirofumi Koike2

  • 1Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.

Circulation Reports
|December 11, 2024
PubMed

Insights

Atrial fibrillation (AF) is linked to worse diastolic function and more severe atrial lesions in cardiac amyloidosis (CA) patients. These findings highlight potential imaging markers for AF risk in CA.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiac Electrophysiology

Background:

  • Atrial fibrillation (AF) is a frequent arrhythmia in patients with cardiac amyloidosis (CA).
  • Previous studies suggest a link between AF, diastolic dysfunction, and atrial lesions in CA.
  • The specific relationship between diastolic function, atrial lesions, and AF in CA requires further investigation.

Purpose of the Study:

  • To evaluate diastolic function and atrial lesions in patients diagnosed with cardiac amyloidosis and atrial fibrillation.
  • To compare echocardiographic and cardiac magnetic resonance imaging (CMRI) findings between CA patients with and without AF.

Main Methods:

  • Retrospective analysis of 27 biopsy-confirmed cardiac amyloidosis patients.
  • Diastolic function assessed using average E/e' via echocardiography.
  • Atrial lesions evaluated by late gadolinium enhancement (LGE) on CMRI.
  • Comparison between 7 patients with AF and 20 patients with sinus rhythm (SR).

Main Results:

  • Patients with AF exhibited significantly higher average E/e' (21.3) compared to SR patients (14.2) (P=0.0053).
  • Atrial LGE was more prevalent and severe in the AF group (100%) versus the SR group (52.4%) (P=0.00228).
  • Higher average E/e' was independently associated with AF in CA patients (OR 1.24, P=0.0251).

Conclusions:

  • Atrial fibrillation in cardiac amyloidosis patients is associated with impaired diastolic function.
  • Increased atrial lesions, visualized by LGE, are more common in CA patients with AF.
  • Diastolic dysfunction and atrial lesions may serve as indicators for AF risk in cardiac amyloidosis.
Abstract

Keywords:
AmyloidosisAtrial fibrillationEchocardiographyMagnetic resonance imaging

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