Complexities of Atrial Fibrosis Imaging

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2025-04-01 DOI:10.1016/j.jacep.2025.02.012

Benjamin Wilk PhD , Heeseung Lim PhD , Justin Hicks PhD , Rebecca Sullivan PhD , Jonathan D. Thiessen PhD , Michael Kovacs PhD , Jane Sykes RVT , Heather Biernaski BSc , Stephen Duffett MD , Frank S. Prato PhD , Allan Skanes MD

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引用次数: 0

Abstract

Background

Atrial fibrillation is associated with abnormal synchronization of left atrial electrical activity and substantially increased risk of myocardial infarction, stroke and heart failure.

Objectives

This study sought to investigate, in a canine model of atrial fibrosis, the relationship between left atrial sympathetic innervation (by ¹¹C-hydroxyephedrine positron emission tomography [PET]), extracellular volume (by magnetic resonance imaging [MRI]) and endocardial voltage (by voltage mapping), measured in vivo with the extent of left atrial (LA) tissue fibrosis measured post mortem with histology.

Methods

A total of 9 adult female canines were imaged with hybrid PET/MRI. The animals were then implanted with a dual chamber pacemaker, and 1 week later, 6 animals were paced at 220 to 240 beats/min for 5 weeks, whereas the other 3 had sham surgeries. After another week, the animals were again imaged with PET/MRI and had voltage maps taken. The animals were then euthanized, hearts were excised, and the extent and location of LA fibrosis was determined using Masson’s trichrome stain.

Results

End-diastolic volume and end-systolic volume increased, sympathetic innervation (measured with PET) increased in the left ventricle and LA, interstitial fibrosis increased in the LA, and extracellular volume increased in the LV. There was no significant correlation of the extent of interstitial fibrosis with bipolar voltage, MRI, or fractional uptake rate. A weak, but significant, negative correlation was found between interstitial fibrosis and unipolar voltage. Delayed enhancement failed to detect LA interstitial fibrosis.

Conclusions

Mild-to-moderate LA interstitial fibrosis may be present before affecting LA voltage maps. PET may be promising for detecting early atrial fibrillation.

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心房纤维化成像的复杂性

背景：心房颤动与左心房电活动异常同步相关，大大增加了心肌梗死、中风和心力衰竭的风险。目的本研究旨在探讨犬心房纤维化模型中左心房交感神经支配（通过11c -羟麻黄碱正电子发射断层扫描[PET]）、细胞外体积（通过磁共振成像[MRI]）和心内膜电压（通过电压测绘）之间的关系，心内膜电压是通过左心房组织纤维化程度在死后的组织学测量来测量的。方法对9只成年母犬进行PET/MRI混合成像。然后给这些动物植入双室起搏器，1周后，6只动物以220 - 240次/分的速度起搏5周，而另外3只动物进行假手术。一周后，再次用PET/MRI对动物进行成像，并拍摄电压图。然后对动物实施安乐死，切除心脏，使用马森三色染色法确定LA纤维化的范围和位置。结果舒张末期体积和收缩末期体积增加，左室和左室交感神经支配（PET测量）增加，左室间质纤维化增加，左室细胞外体积增加。间质纤维化程度与双极电压、MRI或部分摄取率无显著相关性。间质纤维化与单极电压呈微弱但显著的负相关。延迟增强未能检测到LA间质纤维化。结论在影响LA电压图之前可能存在轻度至中度的LA间质纤维化。PET对早期房颤的检测很有希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.