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Left atrial sphericity as a marker of atrial remodeling: Comparison of atrial fibrillation patients and controls.
International Journal of Cardiology ( IF 3.5 ) Pub Date : 2020-01-22 , DOI: 10.1016/j.ijcard.2020.01.042
Mark J Mulder 1 , Michiel J B Kemme 1 , Charlotte L Visser 1 , Luuk H G A Hopman 1 , Pepijn A van Diemen 1 , Peter M van de Ven 2 , Marco J W Götte 1 , Ibrahim Danad 1 , Paul Knaapen 1 , Albert C van Rossum 1 , Cornelis P Allaart 1
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BACKGROUND Left atrial (LA) sphericity has been proposed as a more sensitive marker of atrial fibrillation (AF)-associated atrial remodeling compared to traditional markers such as LA size. However, mechanisms that underlie changes in LA sphericity are not fully understood and studies investigating the predictive value of LA sphericity for AF ablation outcome have yielded conflicting results. The present study aimed to assess correlates of LA sphericity and to compare LA sphericity in subjects with and without AF. METHODS Measures of LA size (LA diameter, LA volume, LA volume index), LA sphericity and thoracic anteroposterior diameter (APd) at the level of the LA were determined using computed tomography (CT) imaging data in 293 AF patients (62% paroxysmal AF) and 110 controls. RESULTS LA diameter (40.1 ± 6.8 mm vs. 35.2 ± 5.1 mm; p < 0.001), LA volume (116.0 ± 33.0 ml vs. 80.3 ± 22.6 ml; p < 0.001) and LA volume index (56.1 ± 15.3 ml/m2 vs. 41.6 ± 11.1 ml/m2; p < 0.001) were significantly larger in AF patients compared to controls, also after adjustment for covariates. LA sphericity did not differ between AF patients and controls (83.7 ± 2.9 vs. 83.9 ± 2.4; p = 0.642). Multivariable linear regression analysis demonstrated that LA diameter, LA volume, female sex, body length and thoracic APd were independently associated with LA sphericity. CONCLUSIONS The present study suggests that thoracic constraints rather than the presence of AF determine LA sphericity, implying LA sphericity to be unsuitable as a marker of AF-related atrial remodeling.

中文翻译:

左心房球形度是心房重构的标志:房颤患者和对照组的比较。

背景技术与诸如LA大小的传统标记相比,已经提出左心房(LA)球形度是与心房纤颤(AF)相关的心房重构的更敏感的标记。但是,尚未完全了解导致LA球形变化的机制,并且研究LA球形对AF消融结果的预测价值的研究得出了相互矛盾的结果。本研究旨在评估LA球形度的相关性,并比较有和没有AF的受试者的LA球形度。方法使用计算机断层扫描(CT)成像数据测定293例AF患者(62%阵发性)的LA大小(LA直径,LA体积,LA体积指数),LA球形度和LA水平的胸廓前后径(APd) AF)和110控件。结果LA直径(40.1±6.8毫米vs. 35.2±5.1毫米; p <0.001),与AF患者相比,AF患者的LA容积(116.0±33.0 ml vs. 80.3±22.6 ml; p <0.001)和LA容​​积指数(56.1±15.3 ml / m2 vs.41.6±11.1 ml / m2; p <0.001)控件,也针对协变量进行了调整。AF患者和对照组之间的LA球形度没有差异(83.7±2.9与83.9±2.4; p = 0.642)。多变量线性回归分析表明,LA的直径,LA的体积,女性,体长和胸廓APd与LA的球形度独立相关。结论本研究表明,胸腔局限性而非房颤的存在决定了洛杉矶的球形性,这暗示洛杉矶球形不适合作为房颤相关性心房重构的标志。校正协变量后,AF患者的001明显高于对照组。AF患者和对照组之间的LA球形度没有差异(83.7±2.9与83.9±2.4; p = 0.642)。多变量线性回归分析表明,LA的直径,LA的体积,女性,体长和胸廓APd与LA的球形度独立相关。结论本研究表明,胸腔局限性而非房颤的存在决定了洛杉矶的球形性,这暗示洛杉矶球形不适合作为房颤相关性心房重构的标志。校正协变量后,AF患者的001明显高于对照组。AF患者和对照组之间的LA球形度没有差异(83.7±2.9与83.9±2.4; p = 0.642)。多变量线性回归分析表明,LA的直径,LA的体积,女性,体长和胸廓APd与LA的球形度独立相关。结论本研究表明,胸腔局限性而非房颤的存在决定了洛杉矶的球形性,这暗示洛杉矶球形不适合作为房颤相关性心房重构的标志。洛杉矶的体积,女性,身长和胸廓APd与洛杉矶的球形度独立相关。结论本研究表明,胸腔局限性而非房颤的存在决定了洛杉矶的球形性,这暗示洛杉矶球形不适合作为房颤相关性心房重构的标志。洛杉矶的体积,女性,身长和胸廓APd与洛杉矶的球形度独立相关。结论本研究表明,胸腔局限性而非房颤的存在决定了洛杉矶的球形,这暗示洛杉矶球形不适合作为房颤相关性心房重构的标志。
更新日期:2020-01-22
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