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Atrial Fibrillation

    
LA data analysis

Physiologic Risk Stratification for Stroke in Atrial Fibrillation

Atrial fibrillation (AF) is a common cardiac arrhythmia, affecting 33.5 million patients worldwide. The most serious complication is stroke, which is generally attributed to embolism of thrombus from the left atrium (LA). Stroke prevention by anticoagulation therapy is highly effective but is associated with significant risk of major bleeding. Therapy management must therefore balance the benefit of stroke reduction against the risk of bleeding complications. Currently, stroke risk estimation is based on the empirically derived clinical CHA2DS2-VASc score which has limited predictive accuracy. Our aim is to to develop a previously unattainable quantitative characterization of LA and LAA geometry, hemodynamics and blood biomarkers in AF patients based on comprehensive atrial MRI, including LA 4D flow MRI. The application in a longitudinal clinical study aims at evaluating evaluate the incremental predictive value of comprehensive atrial MRI and coagulation biomarkers on patient outcome. The ultimate goal is to develop a risk factor profile based on physiologic predictors of thrombus formation – atrial stasis and procoagulant factors – that can enhance the stroke risk prediction and then optimize the use of anticoagulation therapy for stroke prevention.

Investigators: Michael Markl (PhD), Maria Carr (R.T.), Jason Ng (PhD), Daniel C. Lee(MD), James Carr (MD), Jeffrey J Goldberger (MD)

Funding: American Heart Association, National Institutes of Health

Publication:
Left Atrial Flow Velocity Distribution and Flow Coherence Using Four-Dimensional Flow Mri: A Pilot Study Investigating the Impact of Age and Pre- and Postintervention Atrial Fibrillation on Atrial Hemodynamics