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Updated: Sep 5, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Association of Left Atrial Hemodynamics by Magnetic Resonance Imaging With Long-Term Outcomes in Patients With

Mina M Benjamin1, Punit Arora2, Muhammad S Munir2

  • 1Division of Cardiovascular Medicine, Loyola University Medical Center, Maywood, Illinois.

Journal of Magnetic Resonance Imaging : JMRI
|July 8, 2022
PubMed

Insights

Left atrial strain and volumes measured by MRI are linked to adverse outcomes in cardiac amyloidosis (CA) patients. These findings highlight potential imaging biomarkers for predicting mortality and heart failure hospitalizations in CA.

Area of Science:

  • Cardiovascular Imaging
  • Cardiac Amyloidosis Research
  • Clinical Outcomes Prediction

Background:

  • Left atrial (LA) function and strain via MRI are recognized markers for cardiovascular diseases, including cardiac amyloidosis (CA).
  • Previous research has not established the association between LA function/strain patterns and clinical outcomes in CA patients.

Purpose of the Study:

  • To compare LA function and strain using MRI in CA patients against a matched cohort without cardiovascular disease (CVD).
  • To evaluate the association of LA function and strain with long-term clinical outcomes in CA patients.

Main Methods:

  • Retrospective case-control study involving 51 CA patients and 51 matched controls without CVD.
  • Utilized ECG-gated balanced steady-state free precession MRI at 1.5 T to assess LA indexed volumes and reservoir (R), contractile (CT), and conduit (CD) strain.
  • Multivariable regression analysis adjusted for clinical factors to determine associations with all-cause mortality and a composite endpoint of heart failure hospitalization (HFH) or death.

Main Results:

  • CA patients exhibited significantly lower LA strain and higher LA volumes compared to controls.
  • Multivariable analysis revealed that LA contractile strain (ƐCT), indexed minimum LA volume, and indexed maximum LA volume were significantly associated with the composite outcome of death or HFH.
  • Left ventricular ejection fraction (LVEF) was the only independent predictor of all-cause mortality.

Conclusions:

  • LA contractile strain (ƐCT) and indexed minimum and maximum LA volumes are significant predictors of adverse composite outcomes (death or HFH) in patients with cardiac amyloidosis.
  • These MRI-derived LA parameters offer valuable prognostic information for managing CA patients.
Abstract

Keywords:
cardiac amyloidosisfeature trackingleft atrial strainleft atrium

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