{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:24:38Z","timestamp":1790144678911,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:00:00Z","timestamp":1626048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Unexpected high levels of atrial fibrosis are found in individuals with no history of atrial fibrillation (AF). The temporal behavior of atrial fibrosis in this population is still unknown. We sought to investigate the progression and predictors of atrial fibrosis in non\u2010AF individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010AF individuals at baseline who underwent late gadolinium enhancement magnetic resonance imaging (LGE\u2010MRI) for assessment of left atrial (LA) fibrosis at least twice were retrospectively included in this study. The incidence of AF was assessed using review of medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 42 non\u2010AF patients (15 females, 65.9\u2009\u00b1\u20098.6 years old), all patients had a detectable level of LA fibrosis at baseline, ranging from 4.5% to 28.8%, with a mean of 12.9\u2009\u00b1\u20095.9%. LA fibrosis in the second LGE\u2010MRI was significantly higher in all patients compared to the first measurement (mean value of 12.9\u2009\u00b1\u20095.9% vs. 17.34\u2009\u00b1\u20096.8%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Congestive heart failure was a significant clinical predictor of atrial fibrosis progression. The seven patients (16.6%) who developed new\u2010onset AF during follow\u2010up showed a significantly higher degree of LA fibrosis on their second MRI, compared to individuals who stayed in sinus rhythm (20.5\u2009\u00b1\u20096.9% vs. 16.7\u2009\u00b1\u20096.7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Atrial fibrotic remodeling is a dynamic process that is progressively increasing in non\u2010AF patients, accentuated by congestive heart failure. The higher extent of LA remodeling observed in patients who developed AF could highlight either the fact that AF is an expression of a highly dynamic left atrial substrate, or that remodeling processes are accelerated by AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15140","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T08:03:45Z","timestamp":1625126625000},"page":"2140-2147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Atrial fibrosis progression in patients with no history of atrial fibrillation"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-318X","authenticated-orcid":false,"given":"Lilas","family":"Dagher","sequence":"first","affiliation":[{"name":"Department of Cardiology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6977-6569","authenticated-orcid":false,"given":"Hanyuan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0697-3159","authenticated-orcid":false,"given":"Yan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Mitlacher","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Schnupp","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issameddine","family":"Ajmi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Forkmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nassir","family":"Marrouche","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mahnkopf","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg 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