Predictors of Left Atrial Severe Fibrosis in Patients with Nonvalvular Atrial Fibrillation

2020 
: Objective The search for predictors of severe (>35 %) left atrial (LA) fibrosis in patients (pts) with nonvalvular atrial fibrillation (AF) directed for catheter ablation (CA).Materials and Methods 69 pts with nonvalvular AF (57 paroxismal and 12 persistent) aged from 32 to 69 years (mean age 57.1±8.4, 28 females) were included in the study, among them 59 pts (86 %) with arterial hypertension (AH), 24 (34.8 %) - with AH and CAD. Complete physical study, laboratory tests (including NT-proBNP level), comprehensive echocardiography were performed. As a surrogate substrate of LA fibrosis, the area of low-voltage ( 35 % were calculated. Degree IV of fibrosis was considered as severe fibrosis.Results Extent of fibrosis didn't depend on sex, age, body weight, presence of diabetes, CHA2DS2VASc scores, duration of AF history. There was a tendency to smaller Sf in pts with spontaneous termination of AF compared to those who required cardioversion: 7.2 cm2 (4.4; 17.1) and 12.6 cm2 (4.2; 30.5), respectively (p=0.069). Although NT-proBNP level was normal in 62 % of pts ( 128 pg / ml - OR=6.184 (1.01; 37.99), LA volume index >34 ml / m2 - OR=5.92 (1.05; 33.38). According to ROC analysis, the area of the curve AUC = 0.839 (p 35 %) LA fibrosis were LV geometry type in the form of eccentric LV hypertrophy, LA volume index >34 ml / m2 and NT-proBNP >128 pg / ml.
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