BACKGROUND Left atrial (LA) late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging is indicative of fibrosis, and has been correlated with reduced LA function, increased LA volume, and poor procedural outcomes in cohorts with atrial fibrillation (AF). However, the role of LGE as a prognostic biomarker for arrhythmia in cardiac disease has not been examined. METHODS In this study, we assessed LA LGE using a 3D LGE CMR sequence to examine its relationships with new onset atrial arrhythmia, and LA and left ventricular (LV) mechanical function. RESULTS LA LGE images were acquired in 111 patients undergoing CMR imaging, including 66 patients with no prior history of an atrial arrhythmia. During the median follow-up of 2.7 years (interquartile range (IQR) 1.8-3.7 years), 15/66 (23%) of patients developed a new atrial arrhythmia. LA LGE ≥10% of LA myocardial volume was significantly associated with an increased rate of new-onset atrial arrhythmia, with a hazard ratio of 3.16 (95% CI 1.14-8.72), p = 0.026. There were significant relationships between LA LGE and both LA ejection fraction (r = - 0.39, p < 0.0005) and echocardiographic LV septal e' (r = - 0.24, p = 0.04) and septal E/e' (r = 0.31, p = 0.007). CONCLUSIONS Elevated LA LGE is associated with reduced LA function and reduced LV diastolic function. LA LGE is associated with new onset atrial arrhythmia during follow-up.

中文翻译：

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左心房晚期钆增强心血管磁共振的预后和功能意义。

背景 心血管磁共振 (CMR) 成像上的左心房 (LA) 晚期钆增强 (LGE) 表明纤维化，并且与房颤 (AF) 队列中 LA 功能降低、LA 体积增加和手术结果不佳相关. 然而，LGE 作为心脏病心律失常预后生物标志物的作用尚未得到研究。方法 在本研究中，我们使用 3D LGE CMR 序列评估了 LA LGE，以检查其与新发房性心律失常以及 LA 和左心室 (LV) 机械功能的关系。结果 111 名接受 CMR 成像的患者获得了 LA LGE 图像，其中 66 名患者既往无房性心律失常病史。在 2.7 年的中位随访期间（四分位距 (IQR) 1.8-3.7 年），15/66 (23%) 的患者出现了新的房性心律失常。LA LGE ≥ 10% LA 心肌体积与新发房性心律失常发生率增加显着相关，风险比为 3.16 (95% CI 1.14-8.72)，p = 0.026。LA LGE 与 LA 射血分数 (r = - 0.39, p < 0.0005) 和超声心动图左室间隔 e' (r = - 0.24, p = 0.04) 和间隔 E/e' (r = 0.31, p) 之间存在显着关系= 0.007）。结论 LA LGE 升高与 LA 功能降低和 LV 舒张功能降低有关。LA LGE 与随访期间新发房性心律失常有关。LA LGE 与 LA 射血分数 (r = - 0.39, p < 0.0005) 和超声心动图左室间隔 e' (r = - 0.24, p = 0.04) 和间隔 E/e' (r = 0.31, p) 之间存在显着关系= 0.007）。结论 LA LGE 升高与 LA 功能降低和 LV 舒张功能降低有关。LA LGE 与随访期间新发房性心律失常有关。LA LGE 与 LA 射血分数 (r = - 0.39, p < 0.0005) 和超声心动图左室间隔 e' (r = - 0.24, p = 0.04) 和间隔 E/e' (r = 0.31, p) 之间存在显着关系= 0.007）。结论 LA LGE 升高与 LA 功能降低和 LV 舒张功能降低有关。LA LGE 与随访期间新发房性心律失常有关。