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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Association of Left Atrial Function With Mitral Regurgitation: The Atherosclerosis Risk in Communities Study
Chunxiao Zhang1, Wendy Wang2,3, Riccardo M Inciardi4
1Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USA.
Journal of the American Heart Association
|August 12, 2025
Summary
Reduced left atrial (LA) reservoir strain is linked to prevalent and incident mitral regurgitation (MR) in older adults. LA enlargement partially explains this association, independent of atrial fibrillation and heart failure.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Mechanics
Background:
- Left atrial (LA) dysfunction may precede LA enlargement and contribute to mitral regurgitation (MR).
- LA reservoir strain quantifies LA function and its association with MR requires further investigation.
Purpose of the Study:
- To examine the association between LA reservoir strain and both prevalent and incident MR.
- To investigate the role of LA enlargement in the relationship between LA reservoir strain and incident MR.
Main Methods:
- Analysis of Atherosclerosis Risk in Communities (ARIC) study participants with echocardiograms from Visits 5 and 7.
- Measurement of LA reservoir strain at Visit 5 and diagnosis of MR via echocardiography.
- Cross-sectional and prospective analyses using multivariable logistic regression.
Main Results:
- Lower LA reservoir strain was associated with higher odds of prevalent MR (OR, 1.12).
- Lower LA reservoir strain was associated with higher odds of incident MR (OR, 1.18).
- The association with incident MR was partially attenuated by heart failure, atrial fibrillation, and LA volume index.
Conclusions:
- LA reservoir strain is a significant predictor of prevalent and incident MR in older adults.
- LA enlargement partially mediates the association between reduced LA reservoir strain and incident MR.
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