Abstract 14888: Association of Interatrial Conduction and Diffuse Left Ventricular Myocardial Fibrosis Defined by Cardiac Magnetic Resonance: the PRIMERI Study
Background: Abnormal P-terminal force in V1 (PTFV1) is associated with an increased risk of heart failure, stroke, atrial fibrillation (AF) and death. Our goal was to explore the associations of left ventricular (LV) diffuse myocardial fibrosis with electrocardiographic (ECG) measures of left atrial (LA) electrical activity.
Methods: 101 patients (mean age 60.13, 64.36% men, 67.33% Caucasian) with structural heart disease (wide spatial QRS-T angle ≥105° ± Selvester QRS score ≥5 on ECG) but LV ejection fraction >35% underwent clinical evaluation, cardiac magnetic resonance (CMR), and resting ECG. LA function indices (LA volume index) were obtained by multimodality tissue tracking with CMR using 2 and 4 chamber long-axis images. T1 mapping and late gadolinium enhancement (LGE) methods were used to assess diffuse LV myocardial fibrosis and the presence of scar. Amplitude, duration of P-prime in V1 (PPV1), averaged P-duration, PR interval and P-axis were automatically measured using 12SL TM algorithm. PTFV1 was calculated as a product of duration by amplitude of PPV1.
Results: In linear regression after adjustment for age, sex, race, body mass index, LA volumemax index, presence of scar and LV mass index, each decile increase in interstitial myocardial fibrosis was associated with 7.6 mm*ms increase in negative abnormal PTFV1 (95%CI -14.2 to -0.9; P=0.025), 15.3 ms prolongation in PPV1 duration (95%CI 6.9 to 23.8; P=0.001), and 5.4 ms widening in averaged P-duration (95%CI 0.9 to 10.0; P=0.020) Table.
Conclusion: Abnormal PTFV1– especially prolonged PPV1 duration, and averaged P-duration – are associated with interstitial myocardial fibrosis in LV reflecting interatrial conduction delay.
Author Disclosures: T.T. Win: None. B.A. Venkatesh: None. G.J. Volpe: None. N. Mewton: None. P. Rizzi: None. R.K. Sharma: None. D.G. Strauss: None. J.A. Lima: Research Grant; Significant; Toshiba Medical Systems. L.G. Tereshchenko: None.
- © 2014 by American Heart Association, Inc.