Associations between 3D-based Left Atrial Volumetric and Blood Flow Parameters in a Single-Site Cohort of the Multi-Ethnic Study of Atherosclerosis
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Updated: May 12, 2026
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
Maurice Pradella1, Justin J Baraboo1, Anthony Maroun1
1From the Department of Radiology (M.P., J.J.B., A.M., S.Z.L., A.L.D., S.H.C., J.M.H., M.A.C., M.M.), Department of Medicine, Division of Cardiology (R.P., P.G.), and Department of Preventive Medicine (P.G.), Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Suite 1600, Chicago, IL 60611; Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland (M.P.); and Department of Epidemiology, University of Washington, Seattle, Wash (S.R.H.).
Insights
Larger left atrial volume (LAV) and reduced left atrial function correlate with impaired blood flow in the left atrium and appendage. LAV measurement may serve as a surrogate for detecting these flow abnormalities using 4D Flow MRI.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Biomedical Engineering
Background:
- Left atrial volume (LAV) and function are critical indicators of cardiovascular health.
- Impaired hemodynamics within the left atrium (LA) and its appendage (LAA) can precede adverse cardiac events.
- Four-dimensional flow MRI (4D Flow MRI) offers advanced visualization of cardiac blood flow dynamics.
Purpose of the Study:
- To investigate the association between left atrial volume (LAV) and function with impaired three-dimensional hemodynamics.
- To determine if LAV and left atrial emptying fractions (LAEF) correlate with blood flow characteristics like stasis and peak velocity within the LA and LAA.
- To explore the utility of LAV as a surrogate marker for abnormal LA and LAA blood flow.
Main Methods:
- Analysis of a subcohort from the Multi-Ethnic Study of Atherosclerosis using prospective 1.5-T cardiac MRI.
- Quantification of LA and LAA peak velocity and blood stasis using 4D Flow MRI with manual 3D segmentations.
- Calculation of LA emptying fractions (LAEFtotal, LAEFactive, LAEFpassive) from short-axis cine data.
- Stepwise multivariable linear models to assess associations between LAV, LAEF, and flow parameters.
Main Results:
- In 158 participants (mean age 73 years), increased LAEFtotal was linked to decreased LA stasis, and increased LAEFactive to increased LA peak velocity.
- Higher minimum LAV indexed was significantly associated with impaired LAA flow, specifically increased LAA stasis and decreased LAA peak velocity.
- Multivariable models confirmed these associations, highlighting the relationship between LAV, LA function, and hemodynamic abnormalities.
Conclusions:
- Elevated minimum LAV and diminished LA function are associated with impaired blood flow dynamics in the LA and LAA.
- LAV measurement, particularly minimum indexed LAV, may serve as a valuable surrogate for identifying abnormal LA and LAA flow characteristics.
- These findings underscore the importance of assessing LAV and LA function in conjunction with hemodynamic parameters for comprehensive cardiovascular evaluation.
Abstract:
Purpose To investigate associations between left atrial volume (LAV) and function with impaired three-dimensional hemodynamics from four-dimensional flow MRI. Materials and Methods A subcohort of participants from the Multi-Ethnic Study of Atherosclerosis from Northwestern University underwent prospective 1.5-T cardiac MRI including whole-heart four-dimensional flow and short-axis cine imaging between 2019 and 2020. Four-dimensional flow MRI analysis included manual three-dimensional segmentations of the LA and LA appendage (LAA), which were used to quantify LA and LAA peak velocity and blood stasis (% voxels < 0.1 m/sec). Short-axis cine data were used to delineate LA contours on all cardiac time points, and the resulting three-dimensional-based LAVs were extracted for calculation of LA emptying fractions (LAEFtotal, LAEFactive, LAEFpassive). Stepwise multivariable linear models were calculated for each flow parameter (LA stasis, LA peak velocity, LAA stasis, LAA peak velocity) to determine associations with LAV and LAEF. Results This study included 158 participants (mean age, 73 years ± 7 [SD]; 83 [52.5%] female and 75 [47.4%] male participants). In multivariable models, a 1-unit increase of LAEFtotal was associated with decreased LA stasis (β coefficient, -0.47%; P < .001), while increased LAEFactive was associated with increased LA peak velocity (β coefficient, 0.21 cm/sec; P < .001). Furthermore, increased minimum LAV indexed was most associated with impaired LAA flow (higher LAA stasis [β coefficient, 0.65%; P < .001] and lower LAA peak velocity [β coefficient, -0.35 cm/sec; P < .001]). Conclusion Higher minimum LAV and reduced LA function were associated with impaired flow characteristics in the LA and LAA. LAV assessment might therefore be a surrogate measure for LA and LAA flow abnormalities. Keywords: Atherosclerosis, Left Atrial Volume, Left Atrial Blood Flow, 4D Flow MRI Supplemental material is available for this article. © RSNA, 2024.
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