@Article{RSM:Ako2013, 
  author =       "N. Akoum and G. Fernandez and B. Wilson and C. McGann and
                 E. Kholmovski and N. Marrouche",
  title =        "Association of Atrial Fibrosis Quantified Using {LGE-MRI}
                 with Atrial Appendage Thrombus and Spontaneous Contrast on
                 Transesophageal Echocardiography in Patients with Atrial
                 Fibrillation.",
  journal =      j-JCE,
  year =         "2013",
  volume =       "24",
  number =       "10",
  pages =        "1104--1109",
  robnote =      "INTRODUCTION: Transesophageal echocardiography (TEE) is
                 used to evaluate for left atrial appendage (LAA) thrombi
                 prior to restoration of sinus rhythm in atrial
                 fibrillation (AF). We examined the relationship of atrial
                 fibrosis quantified using late gadolinium enhancement MRI
                 (LGE-MRI) with TEE findings. METHODS AND RESULTS: We
                 included 178 patients with AF, undergoing TEE and LGE-MRI
                 prior to ablation or cardioversion. LGE-MRI and subsequent
                 image processing was used to quantify atrial fibrosis
                 based on signal intensity analysis. The mean CHADS2 score
                 was 1.24 +/- 1.08 and CHA2 DS2 -VASc was 2.08 +/- 1.33.
                 The LAA was classified as normal, spontaneous
                 echocardiographic contrast (SEC) present or thrombus
                 present. LAA thrombus was found in 12 patients (6.7\%)
                 while SEC was identified in 19 patients (10.7\%). Patients
                 with thrombus had higher atrial fibrosis compared to
                 patients without thrombus (26.9 +/- 17.4\% vs 16.7 +/-
                 10.5\%; P < 0.01). Atrial fibrosis was also higher in
                 patients with SEC (23.3 +/- 13.7\%) compared to those
                 without SEC (16.7 +/- 10.8\%; P = 0.01). Patients with
                 high atrial fibrosis (>20\%) were more likely to have a
                 LAA thrombus (odds ratio 4.6; P = 0.02) and SEC (odds
                 ratio 2.6; P = 0.06). Multivariate logistic regression
                 showed high fibrosis (odds ratio 3.6; P < 0.01) and CHADS2
                 >/=2 (odds ratio 3.5; P < 0.01) were significant
                 predictors of TEE abnormalities (LAA thrombus or SEC). The
                 area under the curve for the model including high
                 fibrosis, AF type and CHADS2 >/=2 or CHA2 DS2 -VASc >/=2
                 was 0.73 compared to 0.63 and 0.65 for CHADS2 and CHA2 DS2
                 -VASc alone. CONCLUSIONS: Atrial fibrosis is independently
                 associated with appendage thrombus and spontaneous
                 contrast. It provides additional risk stratification not
                 captured by clinical parameters.",
  bibdate =      "Sun May 25 06:14:09 2014",
}

{"_id":"KEEjDBXqfPt7B5jbA","bibbaseid":"akoum-fernandez-wilson-mcgann-kholmovski-marrouche-associationofatrialfibrosisquantifiedusinglgemriwithatrialappendagethrombusandspontaneouscontrastontransesophagealechocardiographyinpatientswithatrialfibrillation-2013","downloads":0,"creationDate":"2016-07-01T21:38:29.033Z","title":"Association of Atrial Fibrosis Quantified Using LGE-MRI with Atrial Appendage Thrombus and Spontaneous Contrast on Transesophageal Echocardiography in Patients with Atrial Fibrillation.","author_short":["Akoum, N.","Fernandez, G.","Wilson, B.","McGann, C.","Kholmovski, E.","Marrouche, N."],"year":2013,"bibtype":"article","biburl":"http://www.sci.utah.edu/~macleod/Bibtex/biglit.bib","bibdata":{"bibtype":"article","type":"article","author":[{"firstnames":["N."],"propositions":[],"lastnames":["Akoum"],"suffixes":[]},{"firstnames":["G."],"propositions":[],"lastnames":["Fernandez"],"suffixes":[]},{"firstnames":["B."],"propositions":[],"lastnames":["Wilson"],"suffixes":[]},{"firstnames":["C."],"propositions":[],"lastnames":["McGann"],"suffixes":[]},{"firstnames":["E."],"propositions":[],"lastnames":["Kholmovski"],"suffixes":[]},{"firstnames":["N."],"propositions":[],"lastnames":["Marrouche"],"suffixes":[]}],"title":"Association of Atrial Fibrosis Quantified Using LGE-MRI with Atrial Appendage Thrombus and Spontaneous Contrast on Transesophageal Echocardiography in Patients with Atrial Fibrillation.","journal":"j-JCE","year":"2013","volume":"24","number":"10","pages":"1104--1109","robnote":"INTRODUCTION: Transesophageal echocardiography (TEE) is used to evaluate for left atrial appendage (LAA) thrombi prior to restoration of sinus rhythm in atrial fibrillation (AF). We examined the relationship of atrial fibrosis quantified using late gadolinium enhancement MRI (LGE-MRI) with TEE findings. METHODS AND RESULTS: We included 178 patients with AF, undergoing TEE and LGE-MRI prior to ablation or cardioversion. LGE-MRI and subsequent image processing was used to quantify atrial fibrosis based on signal intensity analysis. The mean CHADS2 score was 1.24 +/- 1.08 and CHA2 DS2 -VASc was 2.08 +/- 1.33. The LAA was classified as normal, spontaneous echocardiographic contrast (SEC) present or thrombus present. LAA thrombus was found in 12 patients (6.7%) while SEC was identified in 19 patients (10.7%). Patients with thrombus had higher atrial fibrosis compared to patients without thrombus (26.9 +/- 17.4% vs 16.7 +/- 10.5%; P < 0.01). Atrial fibrosis was also higher in patients with SEC (23.3 +/- 13.7%) compared to those without SEC (16.7 +/- 10.8%; P = 0.01). Patients with high atrial fibrosis (>20%) were more likely to have a LAA thrombus (odds ratio 4.6; P = 0.02) and SEC (odds ratio 2.6; P = 0.06). Multivariate logistic regression showed high fibrosis (odds ratio 3.6; P < 0.01) and CHADS2 >/=2 (odds ratio 3.5; P < 0.01) were significant predictors of TEE abnormalities (LAA thrombus or SEC). The area under the curve for the model including high fibrosis, AF type and CHADS2 >/=2 or CHA2 DS2 -VASc >/=2 was 0.73 compared to 0.63 and 0.65 for CHADS2 and CHA2 DS2 -VASc alone. CONCLUSIONS: Atrial fibrosis is independently associated with appendage thrombus and spontaneous contrast. It provides additional risk stratification not captured by clinical parameters.","bibdate":"Sun May 25 06:14:09 2014","bibtex":"@Article{RSM:Ako2013, \n author = \"N. Akoum and G. Fernandez and B. Wilson and C. McGann and\n E. Kholmovski and N. Marrouche\",\n title = \"Association of Atrial Fibrosis Quantified Using {LGE-MRI}\n with Atrial Appendage Thrombus and Spontaneous Contrast on\n Transesophageal Echocardiography in Patients with Atrial\n Fibrillation.\",\n journal = j-JCE,\n year = \"2013\",\n volume = \"24\",\n number = \"10\",\n pages = \"1104--1109\",\n robnote = \"INTRODUCTION: Transesophageal echocardiography (TEE) is\n used to evaluate for left atrial appendage (LAA) thrombi\n prior to restoration of sinus rhythm in atrial\n fibrillation (AF). We examined the relationship of atrial\n fibrosis quantified using late gadolinium enhancement MRI\n (LGE-MRI) with TEE findings. METHODS AND RESULTS: We\n included 178 patients with AF, undergoing TEE and LGE-MRI\n prior to ablation or cardioversion. LGE-MRI and subsequent\n image processing was used to quantify atrial fibrosis\n based on signal intensity analysis. The mean CHADS2 score\n was 1.24 +/- 1.08 and CHA2 DS2 -VASc was 2.08 +/- 1.33.\n The LAA was classified as normal, spontaneous\n echocardiographic contrast (SEC) present or thrombus\n present. LAA thrombus was found in 12 patients (6.7\\%)\n while SEC was identified in 19 patients (10.7\\%). Patients\n with thrombus had higher atrial fibrosis compared to\n patients without thrombus (26.9 +/- 17.4\\% vs 16.7 +/-\n 10.5\\%; P < 0.01). Atrial fibrosis was also higher in\n patients with SEC (23.3 +/- 13.7\\%) compared to those\n without SEC (16.7 +/- 10.8\\%; P = 0.01). Patients with\n high atrial fibrosis (>20\\%) were more likely to have a\n LAA thrombus (odds ratio 4.6; P = 0.02) and SEC (odds\n ratio 2.6; P = 0.06). Multivariate logistic regression\n showed high fibrosis (odds ratio 3.6; P < 0.01) and CHADS2\n >/=2 (odds ratio 3.5; P < 0.01) were significant\n predictors of TEE abnormalities (LAA thrombus or SEC). The\n area under the curve for the model including high\n fibrosis, AF type and CHADS2 >/=2 or CHA2 DS2 -VASc >/=2\n was 0.73 compared to 0.63 and 0.65 for CHADS2 and CHA2 DS2\n -VASc alone. CONCLUSIONS: Atrial fibrosis is independently\n associated with appendage thrombus and spontaneous\n contrast. It provides additional risk stratification not\n captured by clinical parameters.\",\n bibdate = \"Sun May 25 06:14:09 2014\",\n}\n\n","author_short":["Akoum, N.","Fernandez, G.","Wilson, B.","McGann, C.","Kholmovski, E.","Marrouche, N."],"key":"RSM:Ako2013","id":"RSM:Ako2013","bibbaseid":"akoum-fernandez-wilson-mcgann-kholmovski-marrouche-associationofatrialfibrosisquantifiedusinglgemriwithatrialappendagethrombusandspontaneouscontrastontransesophagealechocardiographyinpatientswithatrialfibrillation-2013","role":"author","urls":{},"downloads":0,"html":""},"search_terms":["association","atrial","fibrosis","quantified","using","lge","mri","atrial","appendage","thrombus","spontaneous","contrast","transesophageal","echocardiography","patients","atrial","fibrillation","akoum","fernandez","wilson","mcgann","kholmovski","marrouche"],"keywords":[],"authorIDs":[],"dataSources":["5HG3Kp8zRwDd7FotB"]}