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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Left atrial volume and function assessment by magnetic resonance imaging
Irene E Hof1, Birgitta K Velthuis, Vincent J Van Driel
1Department of Cardiology Department of Radiology, University Medical Center, Utrecht, The Netherlands.
Journal of Cardiovascular Electrophysiology
|May 22, 2010
Summary
The Area Length Method (ALM) for assessing left atrial (LA) volume and function using MRI underestimates volumes and overestimates function compared to the Multiple Slice Method (MSM). However, ALM shows good correlation with MSM for LA volume measurements.
Area of Science:
- Cardiovascular Imaging
- Cardiac MRI Techniques
- Atrial Fibrillation Management
Background:
- Magnetic resonance imaging (MRI) is utilized to assess left atrial (LA) volume and function in atrial fibrillation patients undergoing catheter ablation.
- The Multiple Slice Method (MSM) is the gold standard for LA volume assessment via MRI but is time-intensive due to manual tracing.
- The Area Length Method (ALM) presents a simplified, yet unvalidated, alternative for LA volume assessment using MRI.
Purpose of the Study:
- To compare the accuracy and reliability of the Area Length Method (ALM) against the Multiple Slice Method (MSM) for assessing left atrial (LA) volume and function.
- To evaluate the correlation between ALM and MSM in determining LA end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF).
Main Methods:
- Cardiac MRI scans were acquired before and after catheter ablation in 40 patients with atrial fibrillation.
- Left atrial end-diastolic volume (EDV) and end-systolic volume (ESV) were measured using both the Area Length Method (ALM) and the Multiple Slice Method (MSM).
- Left atrial ejection fraction (LA EF) was calculated as (EDV-ESV)/EDV for both methods, and intraobserver and interobserver variability were assessed.
Main Results:
- The Area Length Method (ALM) resulted in significantly lower mean LA EDV (102 mL vs. 111 mL) and ESV (49 mL vs. 65 mL) compared to the Multiple Slice Method (MSM) (P < 0.001).
- ALM led to an overestimation of LA ejection fraction (EF) by a mean of 11% (54% by ALM vs. 42% by MSM) (P < 0.001).
- Despite systematic differences, ALM demonstrated strong correlations with MSM for LA EDV (r=0.77) and ESV (r=0.85), with no significant differences in variability.
Conclusions:
- The Area Length Method (ALM) significantly underestimates left atrial volumes and overestimates left atrial function when assessed by cardiac MRI.
- ALM shows a strong correlation with the more accurate Multiple Slice Method (MSM) for left atrial volume measurements.
- ALM may serve as a faster, albeit less precise, alternative for LA volume and function assessment in specific clinical scenarios.
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