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Changes in pulmonary vein size and narrowing depend on the cardiac cycle before and after pulmonary vein isolation

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Abstract

Accurate measurement of the pulmonary vein dimension (PVD) is important for determining stenosis and efficacy following pulmonary vein isolation (PVI). Little is known about the quantitative evaluation of the impact of the cardiac cycle on pulmonary vein (PV) morphology before and after PVI. This study aims to investigate variations in the ostial size of the PV during the cardiac cycle before and after PVI and the effect of the cardiac cycle on PV stenosis and reduction rate using cardiac computed tomography (CT). Sixty-eight patients with atrial fibrillation who underwent cardiac CT before and after PVI at our institution between 23 January 2021 and 5 February 2022 were retrospectively analyzed. The maximum and minimum PVD were measured at each segment before and after the PV. Each PV was evaluated according to the PVD reduction rate (ΔPVD), calculated as follows: (1 − post-PVD/pre-PVD) × 100 (%). The average dimension of all PVs at the end-diastolic frame was significantly reduced compared to that at the end-systolic frame before PVI. The average dimensions of the right superior and right inferior PV at the end-diastolic frame were significantly reduced compared with those at the end-systolic frame following PVI. The average reduction rate of dimension-classified stenosis of PVs, except for the left inferior PV at the end-diastolic frame, was significantly reduced compared with that at the end-systolic frame. The cardiac cycle affects PVD assessment, including PV stenosis, after PVI. PVD measurement is recommended to be unified to the end-systolic frame of the cardiac cycle to avoid underestimating PV stenosis before and after PVI, ensuring appropriate management and follow-up.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available but fully anonymized raw data and images will be available from the corresponding author on reasonable request.

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Funding

This research received no grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Kotaro Ouchi, Toru Sakuma, Shunsuke Kisaki & Hiroya Ojiri

  2. Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Kenichi Tokutake & Teiichi Yamane

Authors
  1. Kotaro Ouchi
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  2. Toru Sakuma
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  3. Shunsuke Kisaki
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  4. Kenichi Tokutake
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  5. Teiichi Yamane
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  6. Hiroya Ojiri
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Contributions

Kotaro Ouchi: conceptualization, methodology, validation, formal analysis, data curation, writing—original draft, writing—review and editing, visualization, project administration. Toru Sakuma: methodology, validation, writing—review and editing. Shunsuke Kisaki: validation, formal analysis, data curation. Kenichi Tokutake: investigation, resources. investigation, resources. Teiichi Yamane: investigation, resources. Hiroya Ojiri: supervision.

Corresponding author

Correspondence to Kotaro Ouchi.

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Conflict of interest

Teiichi Yamane received speaker honoraria from DAIICHI SANKYO COMPANY, Ltd., Japan, Boerringer Ingelheim, Abbott Japan, Bristol-Myers Squibb, Medtronic Japan, and Japan LifeLine, and research grants from Boehringer Ingelheim. There is no conflict of interest to disclose directly related to this manuscript. The other authors have no conflict of interest.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki. Approval was obtained from the ethics committee of the Jikei University School of Medicine (Approval number: 34-092(11239)).

Informed consent

The institutional review boards of the participating institutions approved this retrospective study and waived the need for documentation of informed consent. Informed consent was obtained in the form of opt-out on the website.

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Ouchi, K., Sakuma, T., Kisaki, S. et al. Changes in pulmonary vein size and narrowing depend on the cardiac cycle before and after pulmonary vein isolation. Heart Vessels (2024). https://doi.org/10.1007/s00380-024-02378-6

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