Research
Prognostic and functional implications of left atrial late gadolinium enhancement cardiovascular magnetic resonance

https://doi.org/10.1186/s12968-018-0514-3Get rights and content
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Abstract

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.

Keywords

Atrial fibrillation
Left atrium
Ejection fraction
Late gadolinium enhancement
Cardiovascular magnetic resonance

Cited by (0)

Michael Quail and Karl Grunseich contributed equally to this work.