Left atrial fibrosis quantification by late gadolinium-enhanced magnetic resonance: a new method to standardize the thresholds for reproducibility

• DOI: 10.1093/europace/euw219
• Publication Date: 2017-02-12T07:34:31Z
• Authors: Eva M. Benito; Alicia Carlosena-...; Eduard Guasch; Susana Prat-González; Rosario J. Perea; Rosa Figueras; Roger Borràs; David Andreu; Elena Arbelo; J. Maria Tolosana; Felipe Bisbal; Josep Brugada; Antonio Berruezo; Lluis Mont
• Keywords: Intensity

Identification of left atrial (LA) fibrosis through late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) remains controversial due to the heterogeneity and lack reproducibility proposed methods. Our aim is describe a normalized, reproducible, standardized method evaluate LA LGE-CMR.Electrocardiogram- respiratory-gated 3-Tesla LGE-CMR was performed in 10 healthy young volunteers 30 patients with fibrillation (AF): paroxysmal AF, persistent previous AF ablation procedure. Local image intensity ratio (IIR) calculated as absolute pixel mean blood pool ratio. The tissue threshold defined (upper limit normality set at IIR plus 2 SDs). Dense scarring characterized radiofrequency-induced (post-AF patients). Validation groups consisted AFs. upper normal 1.20; values higher than 1.32 (60% maximum post-ablation patients) were considered dense scar. Image between 1.2 identified interstitial fibrosis. Patients AFs had less fibrotic compared patients. Endocardial bipolar voltage correlated values.An identifies individuals. An >1.32 defines results provide consistent, comparable, normalized tool assess arrhythmogenic substrate.