Poster électronique

Comparaison IRM-ETO dans l’évaluation de la dysfonction mécanique auriculaire gauche dans la fibrillation atriale
M. Lederlin (1), A. Jadidi (1), H. Cochet (1), O. Corneloup (2), V. Latrabe (1), P. Jaïs (1), M. Haïssaguerre (1), M. Montaudon (2), F. Laurent (1) - (1) Pessac - France, (2) Bordeaux - France
Congrès 2010
Résumé
Objectifs
La fibrillation atriale (FA) est associée à une sidération de l'atrium et de l'auricule gauche, génératrice d'une stase sanguine. L'échocardiographie trans-oesophagienne (ETO) est l'outil de référence pour évaluer la dysfonction et le risque thrombogène de l'auricule gauche. Notre objectif était de comparer IRM et ETO dans cette indication.
Matériels et méthodes
Quarante cinq patients ont bénéficié d'une ETO et d'une IRM avant ablation de FA. Pour chacune des deux techniques, étaient évaluées la fraction d'éjection (FE) et la vitesse maximale de vidange (VMV) de l'auricule. La présence d'un contraste spontané ou d'un thrombus en ETO était également notée.
Résultats
La FE évaluée en IRM était bien corrélée à la FE et la VMV mesurées en ETO (r=0.79 et r=0.91 respectivement) ainsi qu'à l'existence ou non d'un contraste spontané ou d'un thrombus dans l'auricule. Une corrélation significative mais moins marquée était également retrouvée entre les VMV mesurées en IRM et en ETO (r=0.59).
Conclusion
L'évaluation en IRM de la fonction contractile auriculaire apparaît fiable, tant chez les patients arythmiques que chez ceux en rythme sinusal. L'IRM pourrait à terme être une alternative non invasive à l'ETO permettant de guider l'anticoagulation des patients en FA.
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2017-12-11 04.15 :
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2010-10-24 11.11 :
TISSIER

Si on se met dans le cadre du bilan avant ablation par RF d'ACFA : votre étude fonctionnelle auriculaire peut se greffer à l'étude anatomique de l'atrium gauche en IRM. l'injection de gadolinium vous permettrait d'une part d'augmenter vos statistique en matière de recherche de thrombus intra-cavitaire et d'autre part éventuellement de juger de la présence de fibrose pariétale atriale +/- auriculaire.
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