Arrhythmias & electrophysiologyCohort study
Left ventricular fibrosis on T1 mapping is associated with increased risk of incident atrial fibrillation: results from the multi-ethnic study of atherosclerosis
- prospective cohort
- multivariable Cox models adjusted for CHARGE-AF risk factors
Authors' conclusion
Diffuse LV interstitial fibrosis quantified by ECV independently predicts incident AF and is associated with adverse atrial remodelling, supporting ventricular fibrosis as an early substrate for AF development.
Study context
- Population
- Participants from the multiethnic study of atherosclerosis (MESA) free of atrial fibrillation (AF) at baseline who underwent myocardial T1 mapping between 2010 and 2012
- Participants
- 1,261 participants
- Exposure
- Associations between extracellular volume (ECV) and incident AF
Main finding
As reported in the abstract
Incident AF · median follow-up of 7.82 years
participants developed AF
156
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Incident AF per 1% increase in ECV · adjusted for CHARGE-AF risk factors | 1.105 (1.045–1.168) | P < 0.001 | |
| Incident AF by ECV quartile | 1.914 (1.198–3.058) | P = 0.007 | |
| 0.20.5125Hazard ratio (log scale) |
- Incident AF by ECV quartile: Associations remained significant after adjusting for myocardial scar, left atrial (LA) parameters and LV ejection fraction (LVEF)
LA remodelling
- Higher ECV was associated with adverse LA remodelling, including increased LA volume and impaired atrial emptying
- P < 0.05
- remained associated with AF after LA adjustment
Original publication
Left ventricular fibrosis on T1 mapping is associated with increased risk of incident atrial fibrillation: results from the multi-ethnic study of atherosclerosis. Eur Heart J Cardiovasc Imaging. Published 27 August 2026. doi:10.1093/ehjci/jeag226
Summarised from the published abstract; every number is checked against it