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Left Atrial Remodeling in Hypertrophic Cardiomyopathy and Susceptibility Markers for Atrial Fibrillation Identified by Cardiovascular Magnetic Resonance

In hypertrophic cardiomyopathy (HC), atrial fibrillation (AF) is an important determinant of clinical deterioration due to heart failure or embolic stroke. This study characterizes left atrial (LA) structural and functional parameters to establish markers predictive of AF risk, using cardiovascular... Full description

Journal Title: The American journal of cardiology 2014, Vol.113 (8), p.1394-1400
Main Author: Maron, Barry J., MD
Other Authors: Haas, Tammy S., RN , Maron, Martin S., MD , Lesser, John R., MD , Browning, Joseph A., MD , Chan, Raymond H., MD , Olivotto, Iacopo, MD , Garberich, Ross F., MS , Schwartz, Robert S., MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/24589281
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title: Left Atrial Remodeling in Hypertrophic Cardiomyopathy and Susceptibility Markers for Atrial Fibrillation Identified by Cardiovascular Magnetic Resonance
format: Article
creator:
  • Maron, Barry J., MD
  • Haas, Tammy S., RN
  • Maron, Martin S., MD
  • Lesser, John R., MD
  • Browning, Joseph A., MD
  • Chan, Raymond H., MD
  • Olivotto, Iacopo, MD
  • Garberich, Ross F., MS
  • Schwartz, Robert S., MD
subjects:
  • Abridged Index Medicus
  • Adult
  • Age
  • Atrial fibrillation
  • Atrial Fibrillation - diagnosis
  • Atrial Fibrillation - etiology
  • Atrial Fibrillation - physiopathology
  • Atrial Function, Left - physiology
  • Atrial Remodeling - physiology
  • Cardiac arrhythmia
  • Cardiology
  • Cardiomyopathy
  • Cardiomyopathy, Hypertrophic
  • Cardiomyopathy, Hypertrophic - complications
  • Cardiomyopathy, Hypertrophic - diagnosis
  • Cardiomyopathy, Hypertrophic - physiopathology
  • Cardiovascular
  • Confidence intervals
  • Female
  • Follow-Up Studies
  • Heart
  • Heart Atria - pathology
  • Heart Atria - physiopathology
  • Heart attacks
  • Heart failure
  • Humans
  • Logistics
  • Magnetic Resonance Imaging, Cine - methods
  • Male
  • Medical colleges
  • Middle Aged
  • Multivariate analysis
  • Prognosis
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index
  • Variables
ispartof: The American journal of cardiology, 2014, Vol.113 (8), p.1394-1400
description: In hypertrophic cardiomyopathy (HC), atrial fibrillation (AF) is an important determinant of clinical deterioration due to heart failure or embolic stroke. This study characterizes left atrial (LA) structural and functional parameters to establish markers predictive of AF risk, using cardiovascular magnetic resonance (CMR) imaging. We studied 427 consecutive patients with HC in sinus rhythm with CMR (age 44 ± 18 years), including 41 who developed clinically overt AF after study entry (2.6 ± 2.1 years), 49 patients with AF before CMR, 337 patients with HC but without AF, and 244 normal controls. LA chamber was assessed for absolute and indexed end-diastolic volume (LAEDV), end-systolic volume, and percent ejection fraction (LAEF). In the 41 prospectively studied patients with HC who developed AF during follow-up, LAEDV was significantly greater than in patients without AF (146 ± 48 vs 107 ± 37 ml) or in normal controls (81 ± 24 ml, p
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleLeft Atrial Remodeling in Hypertrophic Cardiomyopathy and Susceptibility Markers for Atrial Fibrillation Identified by Cardiovascular Magnetic Resonance
creatorMaron, Barry J., MD ; Haas, Tammy S., RN ; Maron, Martin S., MD ; Lesser, John R., MD ; Browning, Joseph A., MD ; Chan, Raymond H., MD ; Olivotto, Iacopo, MD ; Garberich, Ross F., MS ; Schwartz, Robert S., MD
creatorcontribMaron, Barry J., MD ; Haas, Tammy S., RN ; Maron, Martin S., MD ; Lesser, John R., MD ; Browning, Joseph A., MD ; Chan, Raymond H., MD ; Olivotto, Iacopo, MD ; Garberich, Ross F., MS ; Schwartz, Robert S., MD
descriptionIn hypertrophic cardiomyopathy (HC), atrial fibrillation (AF) is an important determinant of clinical deterioration due to heart failure or embolic stroke. This study characterizes left atrial (LA) structural and functional parameters to establish markers predictive of AF risk, using cardiovascular magnetic resonance (CMR) imaging. We studied 427 consecutive patients with HC in sinus rhythm with CMR (age 44 ± 18 years), including 41 who developed clinically overt AF after study entry (2.6 ± 2.1 years), 49 patients with AF before CMR, 337 patients with HC but without AF, and 244 normal controls. LA chamber was assessed for absolute and indexed end-diastolic volume (LAEDV), end-systolic volume, and percent ejection fraction (LAEF). In the 41 prospectively studied patients with HC who developed AF during follow-up, LAEDV was significantly greater than in patients without AF (146 ± 48 vs 107 ± 37 ml) or in normal controls (81 ± 24 ml, p <0.001). Percent LAEF was lower in patients developing AF (36 ± 10%) than without AF (46 ± 12%) or controls (55 ± 9%, p <0.001). Multivariate analysis identified LAEF (<38%), LAEDV (≥118 ml), and age (≥40 years) as independently associated with AF occurrence. In conclusion, CMR measures of LA remodeling and dysfunction reliably identified patients with HC at risk for future development of AF. Decrease in LAEF represents a strong novel marker of susceptibility to AF in this disease.
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subjectAbridged Index Medicus ; Adult ; Age ; Atrial fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - etiology ; Atrial Fibrillation - physiopathology ; Atrial Function, Left - physiology ; Atrial Remodeling - physiology ; Cardiac arrhythmia ; Cardiology ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic ; Cardiomyopathy, Hypertrophic - complications ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - physiopathology ; Cardiovascular ; Confidence intervals ; Female ; Follow-Up Studies ; Heart ; Heart Atria - pathology ; Heart Atria - physiopathology ; Heart attacks ; Heart failure ; Humans ; Logistics ; Magnetic Resonance Imaging, Cine - methods ; Male ; Medical colleges ; Middle Aged ; Multivariate analysis ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Severity of Illness Index ; Variables
ispartofThe American journal of cardiology, 2014, Vol.113 (8), p.1394-1400
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5Chan, Raymond H., MD
6Olivotto, Iacopo, MD
7Garberich, Ross F., MS
8Schwartz, Robert S., MD
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0Left Atrial Remodeling in Hypertrophic Cardiomyopathy and Susceptibility Markers for Atrial Fibrillation Identified by Cardiovascular Magnetic Resonance
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descriptionIn hypertrophic cardiomyopathy (HC), atrial fibrillation (AF) is an important determinant of clinical deterioration due to heart failure or embolic stroke. This study characterizes left atrial (LA) structural and functional parameters to establish markers predictive of AF risk, using cardiovascular magnetic resonance (CMR) imaging. We studied 427 consecutive patients with HC in sinus rhythm with CMR (age 44 ± 18 years), including 41 who developed clinically overt AF after study entry (2.6 ± 2.1 years), 49 patients with AF before CMR, 337 patients with HC but without AF, and 244 normal controls. LA chamber was assessed for absolute and indexed end-diastolic volume (LAEDV), end-systolic volume, and percent ejection fraction (LAEF). In the 41 prospectively studied patients with HC who developed AF during follow-up, LAEDV was significantly greater than in patients without AF (146 ± 48 vs 107 ± 37 ml) or in normal controls (81 ± 24 ml, p <0.001). Percent LAEF was lower in patients developing AF (36 ± 10%) than without AF (46 ± 12%) or controls (55 ± 9%, p <0.001). Multivariate analysis identified LAEF (<38%), LAEDV (≥118 ml), and age (≥40 years) as independently associated with AF occurrence. In conclusion, CMR measures of LA remodeling and dysfunction reliably identified patients with HC at risk for future development of AF. Decrease in LAEF represents a strong novel marker of susceptibility to AF in this disease.
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2Age
3Atrial fibrillation
4Atrial Fibrillation - diagnosis
5Atrial Fibrillation - etiology
6Atrial Fibrillation - physiopathology
7Atrial Function, Left - physiology
8Atrial Remodeling - physiology
9Cardiac arrhythmia
10Cardiology
11Cardiomyopathy
12Cardiomyopathy, Hypertrophic
13Cardiomyopathy, Hypertrophic - complications
14Cardiomyopathy, Hypertrophic - diagnosis
15Cardiomyopathy, Hypertrophic - physiopathology
16Cardiovascular
17Confidence intervals
18Female
19Follow-Up Studies
20Heart
21Heart Atria - pathology
22Heart Atria - physiopathology
23Heart attacks
24Heart failure
25Humans
26Logistics
27Magnetic Resonance Imaging, Cine - methods
28Male
29Medical colleges
30Middle Aged
31Multivariate analysis
32Prognosis
33Reproducibility of Results
34Retrospective Studies
35Severity of Illness Index
36Variables
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titleLeft Atrial Remodeling in Hypertrophic Cardiomyopathy and Susceptibility Markers for Atrial Fibrillation Identified by Cardiovascular Magnetic Resonance
authorMaron, Barry J., MD ; Haas, Tammy S., RN ; Maron, Martin S., MD ; Lesser, John R., MD ; Browning, Joseph A., MD ; Chan, Raymond H., MD ; Olivotto, Iacopo, MD ; Garberich, Ross F., MS ; Schwartz, Robert S., MD
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32Prognosis
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35Severity of Illness Index
36Variables
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1Haas, Tammy S., RN
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atitleLeft Atrial Remodeling in Hypertrophic Cardiomyopathy and Susceptibility Markers for Atrial Fibrillation Identified by Cardiovascular Magnetic Resonance
jtitleThe American journal of cardiology
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abstractIn hypertrophic cardiomyopathy (HC), atrial fibrillation (AF) is an important determinant of clinical deterioration due to heart failure or embolic stroke. This study characterizes left atrial (LA) structural and functional parameters to establish markers predictive of AF risk, using cardiovascular magnetic resonance (CMR) imaging. We studied 427 consecutive patients with HC in sinus rhythm with CMR (age 44 ± 18 years), including 41 who developed clinically overt AF after study entry (2.6 ± 2.1 years), 49 patients with AF before CMR, 337 patients with HC but without AF, and 244 normal controls. LA chamber was assessed for absolute and indexed end-diastolic volume (LAEDV), end-systolic volume, and percent ejection fraction (LAEF). In the 41 prospectively studied patients with HC who developed AF during follow-up, LAEDV was significantly greater than in patients without AF (146 ± 48 vs 107 ± 37 ml) or in normal controls (81 ± 24 ml, p <0.001). Percent LAEF was lower in patients developing AF (36 ± 10%) than without AF (46 ± 12%) or controls (55 ± 9%, p <0.001). Multivariate analysis identified LAEF (<38%), LAEDV (≥118 ml), and age (≥40 years) as independently associated with AF occurrence. In conclusion, CMR measures of LA remodeling and dysfunction reliably identified patients with HC at risk for future development of AF. Decrease in LAEF represents a strong novel marker of susceptibility to AF in this disease.
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pmid24589281
doi10.1016/j.amjcard.2013.12.045