Diagnostic value of cardiac magnetic resonance imaging-based left atrial strain analysis for identifying cardiac...

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Cardiac magnetic resonance (CMR) is crucial for assessing myocardial impairments.
• Left atrial (LA) volumetry and function are key indicators of cardiac health.
• Distinguishing between various cardiomyopathies with overlapping phenotypes remains a challenge.

Purpose of the Study:

• To compare the diagnostic accuracy of CMR-based LA volumetry and function, including LA strain analysis, for detecting myocardial impairments.
• To evaluate the effectiveness of LA strain analysis in differentiating between healthy volunteers and patients with heart diseases of different etiologies.
• To assess the prognostic performance of LA strain parameters compared to volumetric and functional assessments.

Main Methods:

• A 3 Tesla (3T) CMR scan was performed on 50 healthy volunteers (HV) and 140 patients with cardiomyopathies.
• Patient groups included hypertensive heart disease (n=40), Fabry disease (n=49), and acute myocarditis (n=51).
• LA volume and strain analysis were conducted using standard long-axis cine acquisition and commercial post-processing software.

Main Results:

• Patients showed significantly impaired LA reservoir, conduit, and booster strain compared to HV (p < 0.001).
• Volumetric LA parameters did not differ significantly between patients and HV (p > 0.05).
• LA reservoir strain demonstrated superior diagnostic accuracy (AUC 0.85) compared to volumetric and functional parameters (e.g., passive emptying fraction AUC 0.78).

Conclusions:

• LA strain parameters effectively distinguish patients with cardiac diseases from healthy individuals.
• LA strain analysis outperforms traditional LA volumetric and functional assessments in diagnosing myocardial impairments.
• This technique is valuable for identifying cardiac conditions with overlapping clinical presentations.