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Updated: Jan 19, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Early detection of left atrial dysfunction assessed by CMR feature tracking in hypertensive patients
Lu Li1, Xiuyu Chen1, Gang Yin1
1Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China.
Insights
Cardiovascular magnetic resonance feature tracking (CMR-FT) can detect early left atrial (LA) reservoir and conduit dysfunction in hypertension patients before left ventricular hypertrophy (LVH) develops. This technique shows promise for quantifying LA function.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertension (HTN) can lead to left atrial (LA) dysfunction, a precursor to cardiovascular events.
- Left ventricular hypertrophy (LVH) is a known complication of HTN, but early LA changes may precede LVH.
- Cardiovascular magnetic resonance feature tracking (CMR-FT) offers a non-invasive method to assess cardiac function.
Purpose of the Study:
- To determine if CMR-FT can detect early LA dysfunction in patients with hypertension, both with and without LVH.
- To evaluate specific LA functions including reservoir, conduit, and booster pump function using CMR-FT.
- To assess the diagnostic performance of CMR-FT parameters in identifying LA dysfunction in HTN.
Main Methods:
- Retrospective analysis of 73 HTN patients (29 with LVH, 44 without) and 29 healthy controls.
- LA function assessed using CMR-FT, quantifying reservoir (EF, εs, SRs), conduit (passive EF, εe, SRe), and booster pump (booster EF, εa, SRa) functions.
- Statistical analysis included ANOVA, Spearman correlation, ROC curve analysis, and ICC for reproducibility.
Main Results:
- HTN patients (with or without LVH) showed impaired LA reservoir and conduit function compared to controls.
- LA conduit dysfunction (specifically passive strain [εe]) demonstrated high diagnostic value (AUC 0.82) for differentiating HTN from controls.
- LA booster pump function was relatively preserved in non-LVH patients, indicating an intermediate stage of dysfunction.
Conclusions:
- CMR-FT is a valuable tool for quantifying LA function, including deformation parameters.
- Early detection of LA reservoir and conduit dysfunction is feasible with CMR-FT in hypertensive individuals, even before LVH is evident.
- CMR-FT provides reliable and reproducible measurements of LA function in the context of hypertension.
Objectives:
To evaluate whether early left atrial (LA) dysfunction in hypertension (HTN), with or without left ventricular hypertrophy (LVH), can be detected by cardiovascular magnetic resonance feature tracking (CMR-FT).
Methods:
Seventy-three HTN patients and 29 healthy controls were retrospectively recruited. HTN patients were divided into the LVH (n = 29) and non-LVH group (n = 44). LA performance was analysed using CMR-FT in 2- and 4-chamber cine images, including LA reservoir function (total ejection fraction [EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive EF, passive strain [εe], peak early negative strain rate [SRe]) and booster pump function (booster EF, active strain [εa], late peak negative strain rate [SRa]). One-way analysis of variance with post hoc LSD tests, Spearman analysis, receiver operating characteristic curve and intra-class correlation coefficient analysis were applied for statistical analyses.
Results:
Compared with healthy controls, LA reservoir (LA total EF, εs, SRs) and conduit function (LA passive EF, εe, SRe) were significantly impaired in HTN patients with or without LVH, and these parameters significantly correlated with mitral E/A < 1 (all p < 0.05). However, LA booster pump function was relatively preserved in non-LVH patients, representing an intermediate stage between the LVH group and controls. Among LA deformation parameters, εe showed the highest diagnostic value for differentiation of HTN patients with healthy controls (AUC, 0.82; sensitivity, 80.82%; specificity, 72.41%). Observer reproducibility was good-excellent (ICC, 0.83-0.97) for all CMR-FT derived parameters.
Conclusions:
CMR-FT is a promising tool for quantification of LA function. LA reservoir and conduit dysfunction might be detected early by CMR-FT in HTN patients before the presence of LVH.
Key Points:
• CMR-FT is a promising tool in quantifying LA function, including deformation and volumetric parameters. • LA reservoir and conduit dysfunction might be detected early by CMR-FT in HTN patients with or without LVH. • The LA booster pump function was relatively preserved in non-LVH patients.
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