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Early-onset atrial fibrillation patients show reduced left ventricular ejection fraction and increased atrial fibrosis

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  1. Explaining deep neural networks for knowledge discovery in electrocardiogram analysis

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Atrial fibrillation (AF) has traditionally been considered an electrical heart disease. However, genetic studies have revealed that the structural architecture of the heart also play a significant role. We evaluated the functional and structural consequences of harboring a titin-truncating variant (TTNtv) in AF patients, using cardiac magnetic resonance (CMR). Seventeen early-onset AF cases carrying a TTNtv, were matched 1:1 with non-AF controls and a replication cohort of early-onset AF cases without TTNtv, and underwent CMR. Cardiac volumes and left atrial late gadolinium enhancement (LA LGE), as a fibrosis proxy, were measured by a blinded operator. Results: AF cases with TTNtv had significantly reduced left ventricular ejection fraction (LVEF) compared with controls (57 ± 4 vs 64 ± 5%, P < 0.001). We obtained similar findings in early-onset AF patients without TTNtv compared with controls (61 ± 4 vs 64 ± 5%, P = 0.02). We furthermore found a statistically significant increase in LA LGE when comparing early-onset AF TTNtv cases with controls. Using state-of-the-art CMR, we found that early-onset AF patients, irrespective of TTNtv carrier status, had reduced LVEF, indicating that early-onset AF might not be as benign as previously thought.

Original languageEnglish
JournalScientific Reports
Volume10
Issue number1
Pages (from-to)10039
ISSN2045-2322
DOIs
Publication statusPublished - 22 Jun 2020

    Research areas

  • Adult, Age of Onset, Atrial Fibrillation/diagnostic imaging, Case-Control Studies, Connectin/genetics, Contrast Media/administration & dosage, Female, Fibrosis, Gadolinium/administration & dosage, Humans, Magnetic Resonance Imaging, Cine, Male, Mutation, Radiographic Image Interpretation, Computer-Assisted, Ventricular Function, Left, Young Adult

ID: 61994907