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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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CMR-Based Risk Stratification for Adverse Outcomes in Chronic Ischemic Left Ventricular Aneurysm Patients

Kairui Bo1, Hui Wang1, Feifei Zhang2

  • 1Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (K.B., H.W., S.S., Y.G., Z.Z., S.L., L.X.).

Academic Radiology
|June 19, 2025
PubMed

Insights

Predicting major adverse cardiovascular events (MACEs) in chronic ischemic left ventricular aneurysm (LVA) is crucial. Combining clinical data with cardiac magnetic resonance (CMR) imaging, especially left atrial strain (LA-εa), improves risk prediction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Predictive Analytics

Background:

  • Chronic ischemic left ventricular aneurysm (LVA) carries a poor prognosis.
  • Effective clinical tools for stratifying MACE risk in LVA patients are lacking.
  • Cardiac magnetic resonance (CMR) imaging offers potential for risk assessment.

Purpose of the Study:

  • To identify independent risk factors for major adverse cardiovascular events (MACEs) in patients with chronic ischemic LVA.
  • To develop a predictive model integrating clinical and CMR features.
  • To evaluate the added value of left atrial strain (LA-εa) in risk prediction.

Main Methods:

  • Retrospective analysis of 243 patients with chronic ischemic LVA from a cohort of 1825 myocardial infarction patients.
  • Univariate and multivariate Cox regression, including LASSO, to identify MACE predictors.
  • Construction of a predictive nomogram incorporating significant clinical and CMR variables.

Main Results:

  • 82 (33.7%) patients experienced MACEs over a median 2.6-year follow-up.
  • Independent predictors included age, NYHA class, LVA diameter, LGE extent, and LA-εa.
  • LA-εa significantly improved model discrimination and reclassification (p<0.001).

Conclusions:

  • A predictive model integrating clinical data and CMR biomarkers effectively identifies MACE risk in LVA.
  • Left atrial strain (LA-εa) is a significant independent predictor of adverse outcomes.
  • This model enhances risk stratification for patients with chronic ischemic LVA.
Abstract

Keywords:
Cardiac magnetic resonanceLate gadolinium enhancementLeft ventricular aneurysmStrain

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