Early Diastolic Dysfunction Detection in Hypertension: CMR-Derived Left Atrial Strain
Weiwei Liao1, Bin Fang1, Yuan Kang1
1Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, 16th Meiguan Avenue, Ganzhou 341000, PR China (W.L., B.F., Y.K., J.Z.).
Academic Radiology
|September 5, 2025
Summary
Cardiac magnetic resonance (CMR)-derived left atrial (LA) strain parameters effectively detect early cardiac dysfunction in hypertension. These markers, particularly reservoir strain (εs), show progressive deterioration with left ventricular diastolic dysfunction (LVDD) severity, aiding diagnosis.
Area of Science:
- Cardiovascular Imaging
- Cardiac Dysfunction
- Hypertension Research
Background:
- Hypertension is a major risk factor for cardiac dysfunction, particularly left ventricular diastolic dysfunction (LVDD).
- Early detection of LVDD in hypertensive patients is crucial for timely intervention and management.
- Conventional echocardiographic markers may have limitations in assessing early diastolic impairment.
Purpose of the Study:
- To investigate the role of cardiac magnetic resonance (CMR)-derived left atrial (LA) strain parameters in evaluating early cardiac dysfunction in hypertensive patients.
- To assess the diagnostic utility of LA strain parameters for detecting left ventricular diastolic dysfunction (LVDD) in hypertension.
- To evaluate the correlation of LA strain with conventional diastolic markers and to develop a diagnostic model.
Main Methods:
- Retrospective analysis of 150 hypertensive patients and 60 healthy controls undergoing echocardiography and CMR.
- Quantification of LA strain (reservoir, conduit, booster pump) using CMR feature-tracking (CMR-FT).
- Stratification of hypertensive patients by LVDD severity and correlation analysis with diastolic markers; ROC analysis for diagnostic utility.
Main Results:
- Hypertensive patients showed impaired LA reservoir (εs) and conduit (εe) strains compared to controls, worsening with LVDD severity.
- LA reservoir strain (εs) was a significant indicator for LVDD detection (AUC 0.856).
- A multivariable model integrating echocardiographic markers, εs, and LA volume improved diagnostic performance (AUC 0.929).
Conclusions:
- CMR-derived LA strain parameters are sensitive early markers for LVDD in hypertensive patients.
- LA strain parameters progressively deteriorate with increasing LVDD severity, offering incremental diagnostic value.
- These imaging biomarkers enhance the early detection and assessment of diastolic dysfunction in hypertension.
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