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Updated: Oct 12, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Association Between Heart Failure With Preserved Left Ventricular Ejection Fraction and Impaired Left Atrial Phasic

Rui Shi1, Ke Shi1, Shan Huang1

  • 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.

Journal of Magnetic Resonance Imaging : JMRI
|November 20, 2021
PubMed

Insights

Left atrial (LA) phasic function is significantly impaired in hypertrophic cardiomyopathy (HCM) patients with heart failure with preserved ejection fraction (HFpEF). This impairment is independent of left ventricular (LV) global longitudinal strain.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Biomedical Engineering

Background:

  • Heart failure (HF) in hypertrophic cardiomyopathy (HCM) often presents as preserved left ventricular (LV) ejection fraction (HFpEF).
  • The specific role of left atrial (LA) phasic function in the development of HFpEF within HCM patients remains unclear.

Purpose of the Study:

  • To investigate the association between LA phasic function and HFpEF in HCM patients.
  • To utilize cardiac magnetic resonance imaging (MRI) feature tracking for this assessment.

Main Methods:

  • Retrospective study of 154 HCM patients, categorized into HFpEF and non-HF groups.
  • Cardiac MRI with feature tracking to evaluate LA reservoir, conduit, and booster pump functions, alongside LV global longitudinal strain (GLS).
  • Statistical analyses included regression and reclassification models to determine independent associations.

Main Results:

  • No significant difference in LV GLS was observed between HFpEF and non-HF groups.
  • Patients with HFpEF exhibited significantly impaired LA reservoir, conduit, and booster pump strain.
  • LA reservoir and booster pump strain were independently associated with HFpEF and improved reclassification models.

Conclusions:

  • Left atrial phasic function is severely compromised in HCM patients with HFpEF.
  • LA function, particularly reservoir and booster pump function, plays a critical role in HFpEF in HCM, independent of LV function.
Abstract

Keywords:
HFpEFcardiac MRI feature trackinghypertrophic cardiomyopathyleft atrial dysfunction

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