Left Atrial Volumetric and Functional Remodeling Post-Pulmonary Vein Isolation: Insights from Cardiac Magnetic Resonance Imaging.

IF 6.1 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2025-08-06 DOI:10.1016/j.jocmr.2025.101937

Nikki van Pouderoijen, Luuk H G A Hopman, Leontine E Wentrup, Joris R de Groot, Michiel J B Kemme, Cornelis P Allaart, Marco J W Götte

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引用次数: 0

Abstract

Aim: To assess left atrial (LA) volumetric and functional remodeling parameters using cardiac magnetic resonance (CMR) imaging early and late after pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients.

Methods and results: This study involved 61 AF patients undergoing radiofrequency (RF) PVI. CMR scans were performed pre-PVI, within 72hours and 3 months post-PVI. LA volumes and strain were assessed using two- and four-chamber cine images. Early AF recurrence was monitored during 3 months follow-up.LAVImin significantly increased early post-PVI (22.5±8.7mL/m² to 25.8±9.9mL/m²,p<0.01). At 3 months, both LAVImin and LAVImax significantly reduced compared to early post-PVI (25.4±8.87mL/m² to 19.4±7.7mL/m²,p<0.001;48.2±12.7mL/m² to 38.7±10.6mL/m²,p<0.001, respectively), as well as compared to baseline (22.5±8.7mL/m² to 20.1±8.5mL/m²,p=0.04;45.6±11.8mL/m² to 39.3±11.2mL/m²,p<0.001, respectively). Early post-PVI, LA emptying fraction (LA EF), LA reservoir, and contractile strain significantly reduced compared to baseline (from 51.6±10.8% to 47.1±8.9%,p<0.01;18.3±4.4% to 15.4±2.9%,p<0.001;8.3±3.1% to 5.4±1.8%,p<0.001, respectively). At 3 months, LA EF, LA reservoir, and contractile strain significantly increased as compared to early post-PVI (from 47.1±8.9% to 50.5±8.6%,p<0.01;15.4±2.9% to 16.8±3.1%,p<0.01;5.4±1.8% to 6.9±2.3%,p<0.001, respectively). However, LA reservoir and contractile strain remained significantly lower compared to baseline (18.3±4.4% to 16.8±3.1%,p=0.02;8.3±3.1% to 6.9±2.3%,p<0.01, respectively). In patients with early AF recurrence (27.9%), LA volume reduction and partial functional recovery was not observed during 3 months post-PVI.

Conclusion: LA volumes significantly reduced 3 months post-PVI. While LA function initially declined, it showed partial recovery at 3 months. However, LA reservoir and contractile strain remained reduced compared to pre-PVI. LA reverse remodeling and partial LA functional recovery only occurred in patients without early AF recurrence.

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肺静脉分离后左心房容量和功能重构：心脏磁共振成像的见解。

目的：应用心脏磁共振（CMR）成像评价房颤（AF）患者肺静脉隔离（PVI）术后早期和晚期左房（LA）容积和功能重构参数。方法和结果：本研究纳入61例接受射频PVI治疗的房颤患者。在pvi前、pvi后72小时和3个月内进行CMR扫描。使用两室和四室电影图像评估LA体积和应变。随访3个月监测房颤早期复发情况。LAVImin显著增加pvi后早期LA体积（22.5±8.7mL/m²至25.8±9.9mL/m²，p2至19.4±7.7mL/m2，p2至38.7±10.6mL/m2，p2至20.1±8.5mL/m2,p=0.04;45.6±11.8mL/m2至39.3±11.2mL/m2），结论：pvi后3个月LA体积显著减少。虽然LA功能开始下降，但在3个月时显示部分恢复。然而，与pvi前相比，LA储层和收缩应变仍有所减少。只有在没有早期房颤复发的患者中才会出现LA的反向重塑和部分LA功能恢复。

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

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.