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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Diastolic function and cardiovascular events in patients with preserved left ventricular ejection fraction. Improving

Ibon Rodriguez-Sanchez1, Inaki Villanueva-Benito2, Urko Agirre3

  • 1Department of Cardiology, Galdakao University Hospital, Biobizkaia Health Research Institute, Osakidetza, Spain.

Frontiers in Cardiovascular Medicine
|July 24, 2025
PubMed

Insights

Diastolic dysfunction in patients with preserved ejection fraction is linked to heart failure, atrial fibrillation, and stroke. Left atrial reservoir strain (LARS) improves risk prediction for these events.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Function

Background:

  • Limited research exists on diastolic function's prognostic value in patients with preserved ejection fraction.
  • Diastolic dysfunction is increasingly recognized as a contributor to cardiovascular events.

Purpose of the Study:

  • To assess the association between diastolic function and a composite of heart failure, atrial fibrillation, or ischemic stroke.
  • To evaluate the incremental value of left atrial reservoir strain (LARS) in risk stratification.

Main Methods:

  • Retrospective analysis of 364 patients with preserved LVEF and sinus rhythm.
  • Categorization into four diastolic function groups based on 2016 guidelines.
  • Primary endpoint: composite of HF, AF, or ischemic stroke; Secondary endpoint: all-cause mortality.
  • LARS measured by 2D speckle tracking.

Main Results:

  • Diastolic dysfunction (IDT and DD-EFP) was independently associated with the composite event.
  • LARS enhanced risk stratification, identifying high-risk patients (DD-EFP and IDT with LARS ≤24%).
  • High-risk groups showed event rates of 34% and 46%.

Conclusions:

  • Diastolic function is a strong predictor of HF, AF, or ischemic stroke in patients with preserved LVEF.
  • LARS improves risk stratification, identifying high-risk individuals needing preventive strategies.
  • Diastolic function and LARS were not linked to all-cause mortality; further validation is needed.
Abstract

Keywords:
atrial fibrillationdiastolic functionheart failureischemic strokeleft atrial strainpreserved LVEFprognosisrisk stratification

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