Imaging, biomarker and invasive assessment of diffuse left ventricular myocardial fibrosis in atrial fibrillation

Gordon A. Begg*, Peter P. Swoboda, Rashed Karim, Tobias Oesterlein, Kawal Rhode, Arun V. Holden, John P. Greenwood, Eduard Shantsila, Gregory Y.H. Lip, Sven Plein, Muzahir H. Tayebjee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background: Using cardiovascular magnetic resonance imaging (CMR), it is possible to detect diffuse fibrosis of the left ventricle (LV) in patients with atrial fibrillation (AF), which may be independently associated with recurrence of AF after ablation. By conducting CMR, clinical, electrophysiology and biomarker assessment we planned to investigate LV myocardial fibrosis in patients undergoing AF ablation. Methods: LV fibrosis was assessed by T1 mapping in 31 patients undergoing percutaneous ablation for AF. Galectin-3, coronary sinus type I collagen C terminal telopeptide (ICTP), and type III procollagen N terminal peptide were measured with ELISA. Comparison was made between groups above and below the median for LV extracellular volume fraction (ECV), followed by regression analysis. Results: On linear regression analysis LV ECV had significant associations with invasive left atrial pressure (Beta 0.49, P = 0.008) and coronary sinus ICTP (Beta 0.75, P < 0.001), which remained significant on multivariable regression. Conclusion: LV fibrosis in patients with AF is associated with left atrial pressure and invasively measured levels of ICTP turnover biomarker.

Original languageEnglish
Article number13
JournalJournal of Cardiovascular Magnetic Resonance
Issue number1
Publication statusPublished - 10 Feb 2020


  • Atrial fibrillation
  • Biomarkers
  • Cardiovascular magnetic resonance imaging
  • Fibrosis
  • Voltage mapping


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