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Updated: May 10, 2026
High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
Published on: July 29, 2011
Presión de enclavamiento capilar pulmonar cardiovascular no invasiva por resonancia magnética predice futura
Maria Kalaitzoglou1, Litten Bertelsen2, Bradley Chambers1
1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Introduction:
Elevated pulmonary capillary wedge pressure (PCWP) is known to drive atrial fibrillation (AF). However, it remains unknown if non-invasive cardiovascular magnetic resonance (CMR)-derived PCWP could predict the future risk of AF. This study investigated whether a CMR-derived measure of PCWP could predict future AF.
Methods:
We enrolled 202 participants (mean age 76.2 ± 4.2 years) from the LOOP study, each receiving implantable loop recorder for continuous rhythm monitoring over 4 years. Cardiovascular magnetic resonance imaging quantified left atrial volume (LAV) and left ventricular mass, allowing calculation of a validated sex-specific equation derived PCWP. Cox proportional hazards analysis identified independent variables associated with incident AF.
Results:
Eighty-six participants (42.6%) manifested AF during follow-up. Individuals with AF exhibited significantly higher CMR-PCWP (16.1 ± 2.8 vs 14.7 ± 2.3 mmHg, P < .01) and greater LAV. Univariate regression highlighted that PCWP ≥16 mmHg was significantly associated with incident AF [hazard ratio (HR): 2.73]. Stepwise Cox regression confirmed that PCWP ≥16 mmHg and the CHARGE-AF score remained independently associated with AF, with PCWP conveying higher HR (2.88, P < .001). Kaplan-Meier analysis reinforced the importance of this threshold for AF onset, demonstrating a significantly increased probability of arrhythmia over time and emphasizing its decisive clinical impact.
Conclusion:
Elevated CMR-PCWP is associated with AF in older, high-stroke-risk individuals, underscoring the role of subclinical diastolic dysfunction in promoting arrhythmogenesis. Incorporating non-invasive PCWP assessment into routine CMR evaluation may enhance risk stratification, allowing prompt identification of at-risk patients and enabling earlier, precise, targeted measures for AF prevention.
