Arrhythmias & electrophysiologyCohort study
From Paroxysmal to Persistent Atrial Fibrillation
- Prospective cohort study
- single-centre
Authors' conclusion
LAPW fibrosis may be an important factor in the progression from PAF to PsAF.
Study context
- Population
- Patients with atrial fibrillation (AF) and healthy volunteers undergoing 18F-AlF-FAPI PET-MRI; separate cardiac surgery cohort with biopsy78 AF, 49 healthy volunteers
- Exposure
- FAPI-PET-MRI atrial fibrosis across AF stages vs healthy volunteers
- Healthy volunteersn = 49reference
- Outcome
- Level of atrial fibrosis (fibroblast activation protein inhibitor (FAPI) positive ratio) in different stages of AF
Main finding
As reported in the abstract
Fibrosis positive ratio
Positive ratio significantly higher in PsAF and PmAF vs PAF and healthy volunteers across all atrial regions
P < 0.05
Observational data: associations, not effects.
Further findings
Discrimination of AF stage by positive ratio
- AUC PAF vs PsAF, LA (cutoff 0.072)
- 0.991
- AUC PAF vs PsAF, left atrium posterior wall (LAPW) (cutoff 0.025)
- 0.983
- AUC PsAF vs PmAF, LA (cutoff 0.382)
- 0.756
Histology (36 surgical patients, 124 tissue fragments)
- Increased fibrotic deposition in regions with increased 18F-FAPI uptake
Original publication
From Paroxysmal to Persistent Atrial Fibrillation. JACC Cardiovasc Imaging. Published 25 June 2025. doi:10.1016/j.jcmg.2025.03.013
Summarised from the published abstract; every number is checked against it