C-REACTIVE PROTEIN LEVELS AND PROGRESSION OF ATRIAL FIBROSIS DETECTED BY DE-MRI IN PATIENTS WITH ATRIAL FIBRILLATION

Abstract

Abstract Category: 26. Clinical Electrophysiology—Supraventricular ArrhythmiasSession-Poster Board Number: 1020-403Authors: Christian Mahnkopf, Nathan Burgon, Alexander Au, Nazem Akoum, Thomas Haslam, Gaston Vergara, Eugene Kholmovski, Rob MacLeod, Nassir Marrouche, Comprehensive Arrhythmia and Research Management (CARMA) Center, University of Utah School of Medici, Salt Lake City, UT Background: Correlation between atrial fibrillation (AF) and CRP has been established. We sought to compare the degree of left atrium (LA) disease based on the amount of fibrosis detected using delayed-enhancement MRI (DE-MRI) with C-reactive protein (CRP) levels as an indicator for reactive versus permanent fibrosis.Methods and Results: 177 patients (109 male; 68.5±0.7 years old) underwent DE-MRI to quantify left atrial structural remodeling (SRM) as a marker for atrial fibrosis. Based on the degree of SRM patients were staged into 4 groups: Utah I (≤5% LA wall enhancement), Utah II (>5% to ≤20%), Utah III (>20% to ≤35%) and Utah IV (>35%) (Figure 1). CRP was measured 5±33 days to DE-MRI examination. Highest level of CRP was found in patients with Utah II (0.61±0.71 mg/dl). Course of CRP showed a significant increase from Utah I to Utah II (0.2±0.17 mg/dl vs. 0.61±0.71 mg/dl; p=0.021) and a decrease from Utah II. To Utah III and to Utah IV (Figure 2). Levels of CRP were comparable in Utah I and Utah IV (0.2±0.17 vs. 0.43±0.53 mg/dl; p =0.338)Conclusion: From our preliminary experience inflammation process is involved in the early stages of atrial structural remodeling in patients with AF as detected using DE-MRI.