SEE PAGE 1311 W ith a prevalence of 1% to 2% worldwide, atrial fibrillation (AF) is the most common cardiac arrhythmia and a major contributor to morbidity and mortality (1). Current pathophysiological data suggest that left atrial (LA) myocardial fibrosis is an important contributor to AF susceptibility (2). Furthermore, longitudinal studies indicate active structural and fibrotic remodeling in the fibrillatory atrium, which, in turn, promotes clinical persistence of the arrhythmia (3–5). Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) is capable of visualizing the degree of structural remodeling in the atria and has been shown to correlate not only with the extent of fibrosis measured in surgical biopsy specimens (6–8) but also the degree of atrial dysfunction on cine CMR (9). In addition, atrial fibrosis, quantified on LGE-CMR, has been shown to correlate with worse AF outcomes after ablation (10,11). The most feared complication from AF is stroke, which is believed to result from blood stasis in the fibrillatory atrium and LA appendage (12,13). Previous studies have described an association between thromboembolic events and atrial fibrosis detected on LGE-CMR. In a previous retrospective study by Daccarett et al. (14), the burden of atrial fibrosis was significantly higher in patients with a history of stroke compared with those without previous stroke

中文翻译：

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心房颤动是血栓性心房的必要组成部分吗？＊

参见第 1311 页 心房颤动 (AF) 是最常见的心律失常，也是发病率和死亡率的主要原因，全世界的患病率为 1% 至 2% (1)。目前的病理生理学数据表明，左心房 (LA) 心肌纤维化是导致 AF 易感性的重要因素 (2)。此外，纵向研究表明，心房颤动的结构和纤维化重构活跃，这反过来又促进了心律失常的临床持续性 (3-5)。晚期钆增强心脏磁共振 (LGE-CMR) 能够显示心房结构重构的程度，并且已被证明不仅与手术活检标本中测量的纤维化程度相关 (6-8)，而且与电影 CMR 上心房功能障碍的程度 (9)。此外，在 LGE-CMR 上量化的心房纤维化，已被证明与消融后更差的 AF 结果相关 (10,11)。AF 最可怕的并发症是中风，据信这是由房颤和 LA 附件中的血瘀引起的 (12,13)​​。以前的研究描述了血栓栓塞事件与 LGE-CMR 检测到的心房纤维化之间的关联。在 Daccarett 等人之前的一项回顾性研究中。(14) 有卒中史的患者心房纤维化负担显着高于无卒中史的患者 以前的研究描述了血栓栓塞事件与 LGE-CMR 检测到的心房纤维化之间的关联。在 Daccarett 等人之前的一项回顾性研究中。(14) 有卒中史的患者心房纤维化负担显着高于无卒中史的患者 以前的研究描述了血栓栓塞事件与 LGE-CMR 检测到的心房纤维化之间的关联。在 Daccarett 等人之前的一项回顾性研究中。(14) 有卒中史的患者心房纤维化负担显着高于无卒中史的患者