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

J Cardiovasc Magn Reson. 2020 Feb 10;22(1):13. doi: 10.1186/s12968-020-0603-y.


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.

Keywords: Atrial fibrillation; Biomarkers; Cardiovascular magnetic resonance imaging; Fibrosis; Voltage mapping.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation / blood
  • Atrial Fibrillation / diagnostic imaging*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery
  • Atrial Function, Left
  • Atrial Pressure
  • Biomarkers / blood
  • Blood Proteins
  • Catheter Ablation
  • Collagen Type I / blood
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Fibrosis
  • Galectin 3 / blood
  • Galectins
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / metabolism
  • Heart Ventricles / physiopathology
  • Humans
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Peptide Fragments / blood
  • Peptides / blood
  • Predictive Value of Tests
  • Procollagen / blood
  • Ventricular Function, Left*
  • Ventricular Remodeling*


  • Biomarkers
  • Blood Proteins
  • Collagen Type I
  • Galectin 3
  • Galectins
  • LGALS3 protein, human
  • Peptide Fragments
  • Peptides
  • Procollagen
  • collagen type I trimeric cross-linked peptide
  • procollagen Type III-N-terminal peptide