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Correlation between left ventricular myocardial fibrosis and left atrial dysfunction in patients with non-obstructive

Yan Zheng1,2, Xiaochun Zhang3, Huairong Zhang1

  • 1Department of Radiology, General Hospital of Ningxia Medical University, Yichuan 750004, China.

The British Journal of Radiology
|September 27, 2025
PubMed

Insights

Left ventricular myocardial fibrosis significantly impairs left atrial function in non-obstructive hypertrophic cardiomyopathy (NOHCM). As fibrosis worsens, atrial function declines, indicating a crucial interaction driving disease progression.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac MRI

Background:

  • Non-obstructive hypertrophic cardiomyopathy (NOHCM) is characterized by left ventricular hypertrophy without significant outflow tract obstruction.
  • Left ventricular myocardial fibrosis is increasingly recognized as a key determinant of cardiac dysfunction in NOHCM.
  • The impact of fibrosis on left atrial (LA) function in NOHCM requires further elucidation.

Purpose of the Study:

  • To investigate the relationship between left ventricular myocardial fibrosis and left atrial function in patients with NOHCM.
  • To assess how varying degrees of fibrosis correlate with specific parameters of left atrial strain and strain rate.

Main Methods:

  • Retrospective analysis of 103 NOHCM patients and 28 healthy controls using cardiac magnetic resonance imaging (CMR).
  • Stratification of NOHCM patients based on late gadolinium enhancement (LGE) percentage into four groups: LGE (-), mild, moderate, and severe.
  • Assessment of left atrial strain (εs, εe, εa) and strain rate (SRs, SRe, SRa) using CMR-derived feature tracking (CMR-FT).

Main Results:

  • Left atrial function and volume parameters showed no significant difference between LGE (-) and mild LGE% (+) groups.
  • Progressive decline in left atrial strain (εs, εe, εa) and strain rate (SRs, SRe, SRa) was observed with increasing fibrosis severity (mild, moderate, severe).
  • Significant correlations were found between the degree of left ventricular myocardial fibrosis and various left atrial function and volume parameters (LAEF, LAEDV, LAESV, εs, εe, εa, SRs, SRe, SRa).

Conclusions:

  • Left ventricular myocardial fibrosis is strongly associated with impaired left atrial function in NOHCM.
  • Progressive fibrosis leads to further deterioration of left atrial function, suggesting a detrimental interaction.
  • These findings highlight the importance of assessing myocardial fibrosis in NOHCM to understand disease progression and guide management.
Abstract

Keywords:
cardiac magnetic resonanceleft atrial functionmyocardial fibrosisnon-obstructive hypertrophic cardiomyopathy

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