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Updated: Aug 18, 2025
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Effect of Infarct Location and Size on Left Atrial Function: A Cardiovascular Magnetic Resonance Feature Tracking
He Zhang1, Zhaoxin Tian1, Huaibi Huo1
1Department of Radiology, The First Hospital of China Medical University, Shenyang 110001, China.
Insights
Myocardial infarction size, not location, significantly impacts left atrial (LA) function and remodeling. Larger infarcts (>15%) lead to more pronounced LA dysfunction and volume changes, highlighting size as a critical factor in cardiovascular disease progression.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiovascular Physiology
Background:
- Left atrial (LA) function is a key prognostic indicator in cardiovascular diseases.
- Cardiovascular magnetic resonance feature tracking (CMR-FT) offers a promising method for evaluating LA function.
- The influence of myocardial infarction (MI) size and location on LA function remains incompletely understood.
Purpose of the Study:
- To investigate the impact of myocardial infarction (MI) location and size on left atrial (LA) function using CMR-FT.
- To compare LA function in patients with anterior MI, non-anterior MI, and healthy controls.
- To determine the relationship between MI characteristics and LA remodeling and dysfunction.
Main Methods:
- Retrospective study analyzing 42 anterior MI, 40 non-anterior MI patients, and 47 controls.
- Utilized 3.0T MRI with SSFP and PSIR sequences.
- Assessed infarct size and location via late-gadolinium enhancement (LGE); analyzed LA reservoir, conduit, and booster pump function using CMR-FT.
Main Results:
- Anterior MI patients showed impaired LA reservoir, conduit, and booster pump function compared to controls.
- Non-anterior MI patients exhibited reduced LA strain but preserved LA ejection fraction.
- LA morphology and function differences between anterior and non-anterior MI were not significant after adjusting for MI area.
- Patients with MI size > 15% had increased LA volumes and reduced LA function compared to those with MI size ≤ 15%.
Conclusions:
- Myocardial infarction location does not significantly affect left atrial morphology or function.
- Left atrial dysfunction and remodeling are more pronounced in patients with larger MI size (>15%).
- MI size is a critical determinant of post-infarction left atrial impairment.
Abstract:
Background: LA function has been recognized as a significant prognostic marker in many cardiovascular diseases. Cardiovascular magnetic resonance feature tracking (CMR-FT) represents a promising technique for left atrial function evaluation. The size and location of myocardial infarction are important factors in the cause of adverse left ventricular remodeling, but the effect on the left atriam is unclear. Purpose: to investigate the effect of location and size of previous myocardial infarction (MI) on LA function using CMR-FT. Study type: retrospective. Population: patients formerly diagnosed with anterior MI (n = 42) or non-anterior MI (n = 40) and healthy controls (n = 47). Field Strength/Sequence: a 3.0T MR, Steady state free precession (SSFP), Phase-sensitive inversion recovery (PSIR). Assessment: infarct location and size were assigned and quantified by late-gadolinium enhancement (LGE) imaging. LA performance was analyzed using CMR-FT in 2- and 4-chamber cine images, including LA reservoir, conduit and booster pump function. Statistics: descriptive statistics, ANOVA with post Bonferroni correction, Kruskal−Wallis H, Spearman’s correlation, intraclass correlation coefficient. Results: Anterior MI patients had impaired LA reservoir function (LATEF, εs, SRs), conduit function (LAPEF, εe, SRs) and booster pump function (LAAEF, εa) compared with controls (p < 0.05). Non-anterior MI patients had impaired LA strain (εs, εe, εa; p < 0.05) but preserved LAEFs (p > 0.05). After adjusting the area of MI, there was no significant difference in the LA morphology and function between the anterior and non-anterior wall groups. Stratification analysis by MI size revealed that LA volumes and LAEFs were unchanged in patients with MI size ≤ 15% compared with controls (p > 0.05); only εs and εe were decreased (p < 0.05). Increased LAVIpre-a, LAVImin and decreased LATEF, and LAAEF were found in patients with MI size > 15% compared with the MI size ≤ 15% group (p < 0.05). LVSVI, εs and MI size were significant correlated with LAVI pre-a in multiple stepwise regression analysis. Data conclusions: The location of myocardial infarction is not a major factor affecting the morphology and function of the left atrium. Patients with MI size > 15% experience more pronounced post-infarction LA remodeling and dysfunction than MI size ≤ 15% patients.
