Comparison of Pulmonary Venous and Left Atrial Remodeling in Patients With Atrial Fibrillation With Hypertrophic Cardiomyopathy Versus With Hypertensive Heart Disease

• Published in: The American journal of cardiology 2017-04, Vol.119 (8), p.1262-1268
• Main Authors: Yoshida, Kentaro, MD, Hasebe, Hideyuki, MD, Tsumagari, Yasuaki, MD, Tsuneoka, Hidekazu, MD, Ebine, Mari, Uehara, Yoshiko, BSN, Seo, Yoshihiro, MD, Aonuma, Kazutaka, MD, Takeyasu, Noriyuki, MD
• Format: Article
• Language: English
• Subjects: Ablation; Aged; Anatomy; Angiography; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Atrial Natriuretic Factor - blood; Atrial Remodeling - physiology; Atrium; Biomarkers; Biomarkers - blood; Blood Pressure - physiology; Brain; Brain natriuretic peptide; Calcium-binding protein; Cardiac arrhythmia; Cardiomyocytes; Cardiomyopathy; Cardiomyopathy, Hypertrophic - diagnostic imaging; Cardiomyopathy, Hypertrophic - physiopathology; Cardiovascular; Cardiovascular disease; Cardiovascular diseases; Case-Control Studies; Catheter Ablation; Catheters; Computed tomography; Computer programs; Coronary artery disease; Correlation analysis; Diameters; Drugs; Female; Fibrillation; Fibrosis; Gene mapping; Genetics; Health risks; Heart; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart diseases; Heart Diseases - physiopathology; Humans; Hypertension; Hypertension - physiopathology; Imaging, Three-Dimensional; Magnetic resonance imaging; Male; Medical imaging; Medical instruments; Mercury; Middle Aged; Natriuretic Peptide, Brain - blood; Neuroimaging; Peptides; Pulmonary Veins - diagnostic imaging; Pulmonary Veins - physiopathology; Renal function; Resonance; Sheaths; Statistics; Surgery; Tomography; Tomography, X-Ray Computed; Troponin T - blood; Variance analysis; Vascular Remodeling - physiology; Velocity; Ventricle; Ventricles (cerebral)
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.12.025

Left ventricular diastolic dysfunction in hypertrophic cardiomyopathy (HC) increases susceptibility to atrial fibrillation. Although phenotypical characteristics of the hypertrophied left ventricle are clear, left atrial (LA) and pulmonary venous (PV) remodeling has rarely been investigated. This study aimed to identify differences in LA and PV remodeling between HC and hypertensive heart disease (HHD) using 3-dimensional computed tomography. Included were 33 consecutive patients with HC, 25 with HHD, and 29 without any co-morbidities who were referred for catheter ablation of atrial fibrillation. Pre-ablation plasma atrial and brain natriuretic peptide levels, post-ablation troponin T level, and LA pressure were measured, and LA and PV diameters were determined 3 dimensionally. LA transverse diameter in the control group was smaller than that in the HHD or HC group (55 ± 6 vs 63 ± 9 vs 65 ± 12 mm, p = 0.0003). PV diameter in all 4 PVs was greatest in the HC group and second greatest in the HHD group (21.0 ± 3.1 vs 23.8 ± 2.8 vs 26.8 ± 4.1 mm, p