Role of imaging in assessment of atrial fibrosis in patients with atrial fibrillation: state-of-the-art review

Longobardo, Luca; Todaro, Maria Chiara; Zito, Concetta; Piccione, Maurizio Cusmà; Bella, Gianluca Di; Oreto, Lilia; Khandheria, Bijoy K.; Carerj, Scipione

doi:10.1093/ehjci/jet116

Cited by 67 publications

(51 citation statements)

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“…As demonstrated by the present study, impairment in the reservoir function was detected even before atrial dilatation occurred. This was due to atrial fibrosis and reduced atrial compliance (11) . LA size has an important role in the onset and recurrence of AF.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the use of atrial strain analysis for early detection of functional remodeling, even before anatomical alterations have taken place, may allow us to predict the risk for AF recurrence. Increased interstitial fibrosis and a high likelihood of local intra-atrial conduction block were considered the cause of susceptibility to AF (11) . Compared with traditional parameters, LA strain was shown to be a better predictor of the degree of fibrosis and to have a close correlation with histological findings on the atrial wall in patients undergoing surgical correction for severe primary mitral regurgitation (12) .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the corresponding reduction in atrial strain was significantly greater in patients with chronic AF than in those with paroxysmal AF (3) . Reduced atrial deformation during the reservoir phase of the cardiac cycle may be an early and non-invasive marker of the amount of atrial wall fibrosis (11) . Galectin-3 is a β-galactosidase-binding lectin that is highly expressed in fibrotic tissues.…”

Section: Discussionmentioning

confidence: 99%

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Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

Kılıçgedik¹,

Efe²,

Gürbüz³

et al. 2017

Kosuyolu Heart Journal

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Introduction: Recent studies have shown a significant association between left atrial (LA) global longitudinal strain (GLS) and the progression of atrial fibrillation (AF) with significantly decreased LA GLS in patients with paroxysmal AF. Significantly higher levels of serum galectin-3 have also been found in patients with non-valvular AF. This study aimed to examine the relationship of the early stage of atrial fibrosis and reduced atrial deformation with serum galectin-3 concentration in middle-aged patients with a first episode of nonvalvular AF. Patients and Methods:This study prospectively enrolled 34 patients who were admitted to our emergency department and required either a medical or electrical cardioversion due to the first episode of AF, without any structural or coronary heart disease and with normal LA size. Additionally, 31 control subjects were also enrolled. The diameter, volume, and mechanical function of LA, including strain (S) and strain rate (SR), and serum galectin-3 levels were measured. Results:The average age was 48.5 ± 10.4 years. Galectin-3 values were not significantly different between the AF and control groups (r= 0.42; p= 0.51) and were found to correlate inversely with peak negative SR on apical four chamber (r= −0.31, p= 0.02) and two chamber (r= −0.25, p= 0.04) views. In comparison to the control group, the AF group had significantly lower values of peak systolic S on four chamber view (p= 0.037), peak late diastolic S (p= 0.04), peak positive SR on apical four-chamber view (p= 0.04), and peak late negative SR on apical four chamber (p= 0.03) and two-chamber (p= 0.02) views. Conclusion:Middle-aged patients with the first episode of AF and normal LA sizes had reduced LA reservoir and active atrial functions. Although beginning signs of LA functional remodeling were shown on S and SR imaging, these were not completely reflected by serum galectin-3 levels.Key Words: Atrial fibrillation; strain; strain rate; galectin-3 İlk Atak Non-valvular Atrial Fibrilasyonlu Orta Yaşlı Hastalarda Galectin-3 ÖZET Giriş: Biz bu çalışmada ilk atak non-valvular atriyal fibrilasyon (AF)'lu orta yaşlı hasta grubunda serum galectin konsantrasyonu ile AF erken evresi arasındaki ilişkiyi araştırdık. Hastalar ve Yöntem:Bu çalışmaya acil servisimize ilk atak AF ile başvuran, medikal ya da elektriki kardiyoversiyon yapılmış, yapısal ya da koroner kalp hastalığı olmayan normal LA boyuta sahip 34 hasta ve 31 kontrol hastası prospektif olarak dahil edildi. Ekokardiyografik bulgular kayıt altına alındı ve serum galectin düzeyleri ekokardiyografi öncesi alınan kan örneklerinden ölçüldü. Bulgular:Hastaların ortalama yaşı 48.5 ± 10.4 yıldı. Galectin değerleri arasında AF ve kontrol grubu arasında anlamlı fark saptanmadı (r= 0.42 ; p= 0.51) ve apikal dört boşluk (r= -0.31, p= 0.02) ve iki boşluk görüntü-den (r= -0.25 , p= 0.04) pik negatif SR ile negatif korele bulundu. Kontrol grubu ile karşılaştırıldığında, AF grubunda dört boşluk görüntüden pik sistolik strain (p= 0.037), pik geç diastolik strain (p= 0.0...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

Kılıçgedik¹,

Efe²,

Gürbüz³

et al. 2017

Kosuyolu Heart Journal

View full text Add to dashboard Cite

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“…It has been shown that a good correlation exists in the degree of fibrosis defined by histopathology with that detected by MRI. The degree of fibrosis as defined by MRI is a predictor of recurrence of atrial fibrillation after ablation [57,58,59,60,61]. …”

Section: Evaluation Of La Structure and Functionmentioning

confidence: 99%

“…Thus, it appears that tissue characterization by cardiac MRI and functional strain analysis will play a pivotal role in the overall assessment of atrial structure and function in the years to come [57]. …”

Section: Evaluation Of La Structure and Functionmentioning

confidence: 99%

The Left Atrium: From the Research Laboratory to the Clinic

et al. 2014

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Studies of left atrial (LA) function, until the latter part of the 20th century, were mostly limited to experimental animal models and to studies related to clinical research in the cardiac catheterization laboratory. For this reason, LA function has received considerably less attention than left ventricular (LV) functions, even though evidence suggests that LA myopathy and failure may exist as an isolated entity, precede and/or coexist with LV myopathy. The introduction of echocardiography and Doppler echocardiography in clinical practice has contributed significantly to our understanding of LA function and its interrelationships with the LV, aorta, pulmonary artery and other parts of the cardiovascular system. In addition, LA with the secretion of atrial natriuretic peptides is playing an important role in cardiovascular and neurohumoral homeostasis. Today, it is well known that LA structural and functional abnormalities that are present in many diseases and disorders constitute a powerful prognostic indicator. As technology (echocardiography, magnetic resonance imaging, computed tomography and others) continues to evolve, it is expected that, in the near future, LA structure and function will be routinely used as LV function is used today.

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