Transthoracic echocardiographic backscatter-based assessment of left atrial remodeling involving left atrial and ventricular fibrosis in patients with atrial fibrillation

摘要

Left atrial (LA) fibrosis is a hallmark of atrial structural remodeling [1-3] and is related to recurrence after atrial fibrillation (AF) ablation, but the relationship to left ventricle (LV) fibrosis [4-6] remains unknown. Echocardiography-derived integrated backscatter (IBS) can noninvasively quantify myocardial fibrosis. Therefore, we used IBS to investigate whether a relationship exists between the LA and LV fibro-ses in AF and its impact on the post-ablation results. We studied 113 patients (mean age, 58.6 ± 9.7 years; 56 paroxysmal AF) who underwent their first catheter ablation of AF between September 2010 and January 2014 at Nihon University Itabashi Hospital. The exclusion criteria were: any valvular heart disease (moderate to severe state), LV contraction abnormality, LV hypertrophy, idiopathic cardiomyopathy, chronic pulmonary disease or thyroid disease. Randomly-selected patient records from our institution's echocardio-graphic database from May to August 2013, of 21 age- and sex-matched patients with no evidence of AF or heart disease, were accessed for the control data. All subjects signed a written informed consent, which was approved by the Institutional Review Board of Nihon Univerr sity Itabashi Hospital.