Magnetresonanztomographische Detektion von Fibrose im linken Vorhof bei Patienten nach Schlaganfall

Wandelt, Laura Kristin

dc.contributor.advisor	Staab, Wieland PD Dr.
dc.contributor.author	Wandelt, Laura Kristin
dc.date.accessioned	2019-07-10T13:35:18Z
dc.date.available	2019-07-18T22:50:03Z
dc.date.issued	2019-07-10
dc.identifier.uri	http://hdl.handle.net/21.11130/00-1735-0000-0003-C15E-A
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-7550
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc	610	de
dc.title	Magnetresonanztomographische Detektion von Fibrose im linken Vorhof bei Patienten nach Schlaganfall	de
dc.type	doctoralThesis	de
dc.title.translated	Detection of left atrial fibrosis in patients after ischemic stroke using cardiovascular magnetic resonance imaging	de
dc.contributor.referee	Staab, Wieland PD Dr.
dc.date.examination	2019-07-11
dc.description.abstracteng	Atrial fibrillation is one of the major risk factors for ischemic stroke. Left atrial fibrosis is considered to be a hallmark of the structural remodeling in atrial fibrillation and can be detected and quantified non-invasively using modern, high-resolution 3D late gadolinium enhancement cardiac magnetic resonance imaging. According to the current state of knowledge this is the first study to deal with the detection and quantification of left atrial fibrosis in a study collective with cerebral ischemia but without known atrial fibrillation. It was investigated whether left atrial fibrosis can be linked to a potential detection of paroxysmal atrial fibrillation within the prospective, randomized and controlled Find-AFRANDOMISED study as well as to the cerebral ischemia in the medical history of our study participants. A total of 31 subjects (14 men, 17 women, 70.5 ± 6.2 years) of the Find-AFRANDOMISED study were examined on a 3 Tesla MR scanner of the University Medical Center Göttingen. In 29 subjects the quantification of fibrosis was successful. The median percentage of left atrial fibrosis was 1.6% (minimum: 0.1%, maximum: 3.7%). The obtained extent of left atrial fibrosis is comparable to the extent of left atrial fibrosis of healthy volunteers and also significantly lower than the extent of left atrial fibrosis of patients with atrial fibrillation in comparative studies. The low extent of fibrosis in the present study is thus in agreement with the absence of detection of paroxysmal atrial fibrillation in our study collective within the Find-AFRANDOMISED study. As a consequence, it can be concluded that a slight extent of left atrial fibrosis excludes (paroxysmal) atrial fibrillation with high probability. Furthermore, the additional volumetric and functional analysis of the left atrium revealed normal values for our study collective. Left atrial dilatation and reduction of left atrial function parameters are also characteristic features of atrial fibrillation. The normal values for left atrial volume and phasic function obtained in the present study are therefore also consistent with the absence of detection of (paroxysmal) atrial fibrillation within the Find-AFRANDOMISED study. Neither the extent of left atrial fibrosis nor the results of the left atrial volumetric and functional analysis can provide an explanation for the cerebral ischemia in the medical history of our study participants. In summary, it can be stated that the examined study collective presented with healthy left atria at the time of the MRI examination and that there is no indication of an underlying atrial disease like an “fibrotic atrial cardiomyopathy”. Further studies are needed to ascertain the pathophysiological link between left atrial fibrosis and ischemic stroke in both patients with known atrial fibrillation and patients without atrial fibrillation.	de
dc.contributor.coReferee	Liman, Jan PD Dr.
dc.contributor.thirdReferee	Meyer, Thomas Prof. Dr.
dc.subject.eng	fibrosis	de
dc.subject.eng	left atrium	de
dc.subject.eng	atrial fibrillation	de
dc.subject.eng	ischemic stroke	de
dc.subject.eng	cardiovascular magnetic resonance imaging	de
dc.subject.eng	late gadolinium enhancement	de
dc.subject.eng	left atrial volume	de
dc.subject.eng	left atrial function	de
dc.identifier.urn	urn:nbn:de:gbv:7-21.11130/00-1735-0000-0003-C15E-A-0
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Medizin (PPN619874732)	de
dc.description.embargoed	2019-07-18
dc.identifier.ppn	167230640X

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Human- und Zahnmedizin [2872]

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