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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Incremental prognostic value of left atrial strain in patients with heart failure

Kairui Bo1, Yifeng Gao1, Zhen Zhou1

  • 1Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

ESC Heart Failure
|August 11, 2022
PubMed

Insights

Left atrial reservoir strain (LA-εs) measured by cardiac magnetic resonance (CMR) feature tracking (FT) significantly predicts major adverse cardiac events (MACEs) in heart failure patients. This provides valuable prognostic information beyond traditional risk factors.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiovascular Research

Background:

  • Heart failure with reduced ejection fraction (HFrEF) poses a significant clinical challenge.
  • Dilated cardiomyopathy, both ischemic and non-ischemic, is a common cause of HFrEF.
  • Atrial function assessment may offer novel prognostic insights in HFrEF patients without atrial fibrillation.

Purpose of the Study:

  • To evaluate the prognostic value of left atrial strain (LA-εs) and strain rate (SR) derived from cardiac magnetic resonance (CMR) feature tracking (FT).
  • To assess these parameters in patients with ischemic and non-ischemic dilated cardiomyopathy and HFrEF, excluding those with atrial fibrillation.

Main Methods:

  • Retrospective analysis of 300 patients with CMR, LVEF ≤ 40%, and dilated cardiomyopathy.
  • Utilized CMR feature tracking (FT) to derive left atrial strain (LA-εs) parameters.
  • Assessed major adverse cardiac events (MACEs) including cardiovascular death, heart transplantation, and HF rehospitalization.

Main Results:

  • Lower left atrial reservoir strain (LA-εs) was significantly associated with increased MACE risk in both ischemic and non-ischemic dilated cardiomyopathy patients.
  • LA-εs demonstrated incremental prognostic value over conventional clinical and CMR risk factors.
  • Kaplan-Meier analysis confirmed a significantly higher MACE risk in patients with lower LA-εs tertiles, regardless of late gadolinium enhancement (LGE).

Conclusions:

  • Left atrial reservoir strain (LA-εs) derived from CMR FT is a significant independent predictor of MACEs in patients with dilated cardiomyopathy and HFrEF.
  • These findings highlight the prognostic utility of LA-εs, offering valuable information beyond established risk stratification tools.
  • CMR-derived atrial strain parameters represent a promising tool for risk stratification in HFrEF management.
Abstract

Keywords:
Cardiac magnetic resonanceCardiomyopathyFeature trackingLeft atrial strainPrognosis

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