Computed tomography imaging identified that left atrial walls were significantly thinner (-15.5%, 95% CI -23.2 to -7.8%, P<0.001) and had lower density in atrial fibrillation patients vs controls.
Case-Control (n=187)
Does computed tomography (CT) imaging identify differences in left atrial wall thickness and density between patients with atrial fibrillation and controls?
CT imaging with automated analysis can noninvasively identify significant left atrial wall thinning and regional density alterations in patients with atrial fibrillation.
Effect estimate: Mean difference -15.5% (95% CI -23.2 to -7.8%)
p-value: p=<0.001
INTRODUCTION: Left atrial (LA) tissue characteristics may play an important role in atrial fibrillation (AF) induction and perpetuation. Although frequently used in clinical practice, computed tomography (CT) has not been employed to describe differences in LA wall properties between AF patients and controls. We sought to noninvasively characterize AF-associated differences in LA tissue using CT. METHODS: CT images of the LA were obtained in 98 consecutive patients undergoing AF ablation and in 89 controls. A custom software algorithm was used to measure wall thickness and density in four prespecified regions of the LA. RESULTS: On average, LA walls were thinner (-15.5%, 95% confidence interval CI -23.2 to -7.8%, P < 0.001) and demonstrated significantly lower density (-19.7 Hounsfield Units HU, 95% CI -27.0 to -12.5 HU, P < 0.001) in AF patients compared to controls. In linear mixed models adjusting for demographics, clinical variables, and other CT measurements, the average LA, interatrial septum, LA appendage, and anterior walls remained significantly thinner in AF patients. After adjusting for the same potential confounders, history of AF was associated with reduced density in the LA anterior wall and increased density below the right inferior pulmonary vein and in the LA appendage. CONCLUSION: Application of an automated measurement algorithm to CT imaging of the atrium identified significant thinning of the LA wall and regional alterations in tissue density in patients with a history of AF. These findings suggest differences in LA tissue composition can be noninvasively identified and quantified using CT.
Dewland et al. (Sat,) conducted a case-control in Atrial fibrillation (n=187). Computed tomography (CT) imaging vs. Controls (no atrial fibrillation) was evaluated on Left atrial wall thickness (Mean difference -15.5%, 95% CI -23.2 to -7.8%, p=<0.001). Computed tomography imaging identified that left atrial walls were significantly thinner (-15.5%, 95% CI -23.2 to -7.8%, P<0.001) and had lower density in atrial fibrillation patients vs controls.