Left atrial aging: a cardiac magnetic resonance feature-tracking study

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Left atrial (LA) phasic function is crucial for prognosis and risk stratification.
• Echocardiographic speckle tracking has characterized age-related LA deformation, but MRI-based data are lacking.
• Feature tracking (FT) on cine MRI offers a novel approach to assess LA function.

Purpose of the Study:

• To evaluate age-related variations in LA phasic function using FT on standard cine MRI.
• To correlate these age-related changes with left ventricular (LV) diastolic function.
• To investigate potential sex differences in these associations.

Main Methods:

• 94 healthy adults underwent same-day MRI and echocardiography.
• Dedicated FT software analyzed cine MRI for LA longitudinal strain, strain rate, radial motion fraction, and radial relative velocity during reservoir, conduit, and contraction phases.
• LV diastolic function parameters were assessed using Doppler echocardiography.

Main Results:

• Longitudinal strain and radial motion fraction decreased significantly with age in reservoir and conduit phases.
• LA contraction phase function remained unchanged with age.
• LA contraction-to-reservoir ratio increased significantly with age.
• Longitudinal strain rate and radial relative velocity decreased with age, more pronounced in women.
• Age-related LA changes were stronger in individuals with impaired LV diastolic function.

Conclusions:

• Cine MRI with FT effectively quantifies age-related changes in LA phasic function.
• LA reservoir and conduit functions decline with age, while contraction function is preserved.
• These age-related alterations are linked to LV diastolic function, emphasizing the LV-LA interplay.