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Left Atrial Geometry and Phasic Function Determined by Cardiac Magnetic Resonance Are Independent Predictors for

Bianca Olivia Cojan-Minzat1,2, Alexandru Zlibut1, Ioana Danuta Muresan1

  • 1Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.

Biomedicines
|November 27, 2021
PubMed

Insights

Left atrial (LA) geometry and function, including LA volumes, LA sphericity index (LASI), and LA total strain (LA-εt), are impaired in non-ischaemic dilated cardiomyopathy (NIDCM). These parameters, along with LA late gadolinium enhancement (LA-LGE), predict adverse outcomes in NIDCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiovascular Research

Background:

  • Non-ischaemic dilated cardiomyopathy (NIDCM) often involves impaired left atrial (LA) geometry and function.
  • Cardiac magnetic resonance (CMR) is a valuable tool for assessing LA parameters.

Purpose of the Study:

  • To evaluate the prognostic significance of LA geometry and function in NIDCM patients.
  • To determine if LA parameters, including fibrosis, predict adverse cardiovascular events.

Main Methods:

  • Prospective study of 212 NIDCM patients and 106 controls using CMR.
  • Assessment of LA volumes, phasic functions, geometry (LA sphericity index - LASI), and late gadolinium enhancement (LA-LGE).
  • Follow-up for a composite outcome including cardiac death, ventricular arrhythmias, and heart failure hospitalization.

Main Results:

  • NIDCM patients showed significantly impaired LA function, LASI, and increased LA-LGE compared to controls.
  • LA volumes, LASI, LA total strain (LA-εt), and LA-LGE were independently associated with increased risk of the composite outcome.
  • Adding LASI to LA-εt, and subsequently LA-LGE, incrementally improved the predictive value for adverse events.

Conclusions:

  • Impaired LA geometry and function, particularly LASI, LA-εt, and LA-LGE, are significant independent predictors of adverse outcomes in NIDCM.
  • CMR-derived LA parameters offer incremental prognostic information beyond traditional measures in NIDCM.

Keywords:
cardiac magnetic resonance imagingleft atrial phasic functionleft atrial sphericity indexleft atrial strainleft atrial volumesnon-ischaemic dilated cardiomyopathy

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