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Updated: Nov 6, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Cardiac magnetic resonance derived left atrial strain after ST-elevation myocardial infarction: an independent

Dhruv Nayyar1,2, Tuan Nguyen1,3, Faraz Pathan4,5

  • 1Cardiology Department, Liverpool Hospital, Sydney, NSW, Australia.

Cardiovascular Diagnosis and Therapy
|May 10, 2021
PubMed

Insights

Cardiac magnetic resonance imaging (CMR) derived left atrial (LA) reservoir strain is a strong independent predictor of major adverse cardiovascular events (MACE) after ST-elevation myocardial infarction (STEMI). This finding helps identify high-risk patients for improved outcomes.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomarkers

Background:

  • The prognostic significance of left atrial (LA) function, assessed via cardiac magnetic resonance (CMR), after ST-elevation myocardial infarction (STEMI) is not fully established.
  • Previous studies have yielded controversial results regarding the predictive value of LA strain, ejection fraction (LAEF), and indexed volumes (LAVImax, LAVImin) post-STEMI.

Purpose of the Study:

  • To investigate the relationship between LA function parameters derived from CMR and the occurrence of major adverse cardiovascular events (MACE) in patients following STEMI.
  • To determine if LA strain and other LA parameters can serve as independent predictors of MACE.

Main Methods:

  • A prospective cohort of 202 patients who underwent CMR within 4 days of STEMI were analyzed.
  • Left atrial reservoir strain and LA booster strain were quantified using feature tracking, with measurements averaged from three repeated assessments.
  • Patients were followed for a median of 607 days to track MACE.

Main Results:

  • MACE occurred in 35 patients. Those with MACE exhibited significantly lower LA reservoir strain, LA booster strain, and LAEF compared to those without MACE.
  • Kaplan-Meier analysis revealed that low LA reservoir strain, LA booster strain, and LAEF were associated with a higher risk of MACE.
  • Adding LA reservoir strain to left ventricular ejection fraction (LVEF) improved the predictive accuracy for MACE (AUC increased from 0.713 to 0.775).

Conclusions:

  • CMR-derived LA reservoir strain is an independent predictor of MACE after STEMI, even after adjusting for established risk factors.
  • LA reservoir strain offers valuable prognostic information, potentially aiding in risk stratification and management of post-STEMI patients.
Abstract

Keywords:
Left atrial functionST-elevation myocardial infarction (STEMI)cardiac magnetic resonance (CMR)left atrial strainprognosis

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