{"title":"纤维化-4指数与左心房低电压区和导管消融术后心律失常复发的关系：心房颤动患者的心肝相互作用。","authors":"Shinya Yamada MD, Takashi Kaneshiro MD, Minoru Nodera MD, Kazuaki Amami MD, Takeshi Nehashi MD, Masayoshi Oikawa MD, Takayoshi Yamaki MD, Kazuhiko Nakazato MD, Takafumi Ishida MD, Yasuchika Takeishi MD","doi":"10.1002/joa3.13045","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The relationship between liver fibrosis and left atrial (LA) remodeling in atrial fibrillation (AF) remains uncertain. We examined the associations between the fibrosis-4 (FIB4) index, an indicator of liver fibrosis, and both LA low-voltage areas (LVAs) on electroanatomic mapping and AF recurrence postablation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We recruited 343 patients who underwent radiofrequency catheter ablation (RFCA) or cryoballoon ablation (CBA) for AF. First, the association between the FIB4 index and LA LVAs (<0.5 mV) was evaluated in RFCA using electroanatomic mapping (<i>n</i> = 214). Next, the utility of a FIB4 index ≥1.3, recommended cut-off value of liver fibrosis, was verified to assess the risk for AF recurrence in CBA without additional LVA ablation (<i>n</i> = 129).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Patients with a FIB4 index ≥1.3 had a higher prevalence of LA LVAs (>5 cm<sup>2</sup>) compared to those without. Additionally, the quantitative size of LVAs showed a positive correlation with the FIB4 index (<i>R</i> = .642, <i>p</i> < .001). In multivariate logistic models, a FIB4 index ≥1.3 was related to the presence of LVAs after adjusting for LA diameter, right atrial end-systolic area, and nonparoxysmal AF (odds ratio 2.508; <i>p</i> = 0.039). In CBA, AF recurrence rate was 13.1% during 3–12 months postablation. In multivariate Cox models, a FIB4 index ≥1.3 was an important predictor of AF recurrence (hazard ratio 3.796; <i>p</i> = .037), suggesting that LVAs might be associated with AF recurrence after CBA.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The FIB4 index was a novel predictor of the existence of LA LVAs on electroanatomic mapping and AF recurrence after CBA.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11199833/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associations of the fibrosis-4 index with left atrial low-voltage areas and arrhythmia recurrence after catheter ablation: cardio-hepatic interaction in patients with atrial fibrillation\",\"authors\":\"Shinya Yamada MD, Takashi Kaneshiro MD, Minoru Nodera MD, Kazuaki Amami MD, Takeshi Nehashi MD, Masayoshi Oikawa MD, Takayoshi Yamaki MD, Kazuhiko Nakazato MD, Takafumi Ishida MD, Yasuchika Takeishi MD\",\"doi\":\"10.1002/joa3.13045\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The relationship between liver fibrosis and left atrial (LA) remodeling in atrial fibrillation (AF) remains uncertain. We examined the associations between the fibrosis-4 (FIB4) index, an indicator of liver fibrosis, and both LA low-voltage areas (LVAs) on electroanatomic mapping and AF recurrence postablation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We recruited 343 patients who underwent radiofrequency catheter ablation (RFCA) or cryoballoon ablation (CBA) for AF. First, the association between the FIB4 index and LA LVAs (<0.5 mV) was evaluated in RFCA using electroanatomic mapping (<i>n</i> = 214). Next, the utility of a FIB4 index ≥1.3, recommended cut-off value of liver fibrosis, was verified to assess the risk for AF recurrence in CBA without additional LVA ablation (<i>n</i> = 129).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Patients with a FIB4 index ≥1.3 had a higher prevalence of LA LVAs (>5 cm<sup>2</sup>) compared to those without. Additionally, the quantitative size of LVAs showed a positive correlation with the FIB4 index (<i>R</i> = .642, <i>p</i> < .001). In multivariate logistic models, a FIB4 index ≥1.3 was related to the presence of LVAs after adjusting for LA diameter, right atrial end-systolic area, and nonparoxysmal AF (odds ratio 2.508; <i>p</i> = 0.039). In CBA, AF recurrence rate was 13.1% during 3–12 months postablation. In multivariate Cox models, a FIB4 index ≥1.3 was an important predictor of AF recurrence (hazard ratio 3.796; <i>p</i> = .037), suggesting that LVAs might be associated with AF recurrence after CBA.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The FIB4 index was a novel predictor of the existence of LA LVAs on electroanatomic mapping and AF recurrence after CBA.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15174,\"journal\":{\"name\":\"Journal of Arrhythmia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11199833/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Arrhythmia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/joa3.13045\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.13045","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Associations of the fibrosis-4 index with left atrial low-voltage areas and arrhythmia recurrence after catheter ablation: cardio-hepatic interaction in patients with atrial fibrillation
Background
The relationship between liver fibrosis and left atrial (LA) remodeling in atrial fibrillation (AF) remains uncertain. We examined the associations between the fibrosis-4 (FIB4) index, an indicator of liver fibrosis, and both LA low-voltage areas (LVAs) on electroanatomic mapping and AF recurrence postablation.
Methods
We recruited 343 patients who underwent radiofrequency catheter ablation (RFCA) or cryoballoon ablation (CBA) for AF. First, the association between the FIB4 index and LA LVAs (<0.5 mV) was evaluated in RFCA using electroanatomic mapping (n = 214). Next, the utility of a FIB4 index ≥1.3, recommended cut-off value of liver fibrosis, was verified to assess the risk for AF recurrence in CBA without additional LVA ablation (n = 129).
Results
Patients with a FIB4 index ≥1.3 had a higher prevalence of LA LVAs (>5 cm2) compared to those without. Additionally, the quantitative size of LVAs showed a positive correlation with the FIB4 index (R = .642, p < .001). In multivariate logistic models, a FIB4 index ≥1.3 was related to the presence of LVAs after adjusting for LA diameter, right atrial end-systolic area, and nonparoxysmal AF (odds ratio 2.508; p = 0.039). In CBA, AF recurrence rate was 13.1% during 3–12 months postablation. In multivariate Cox models, a FIB4 index ≥1.3 was an important predictor of AF recurrence (hazard ratio 3.796; p = .037), suggesting that LVAs might be associated with AF recurrence after CBA.
Conclusion
The FIB4 index was a novel predictor of the existence of LA LVAs on electroanatomic mapping and AF recurrence after CBA.
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