Related Experiment Video

Updated: May 29, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

Atrial Function by Long Axis Shortening Enhances Risk Stratification Beyond Traditional CMR Markers in Possible

Nicola Ciocca1, Delia Brändle2, Lars Riederer1

  • 1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

JACC. Cardiovascular Imaging
|May 28, 2026
PubMed

Insights

Atrial dysfunction, measured by atrial long axis shortening (LAS) via cardiac magnetic resonance (CMR), independently predicts adverse cardiovascular events in patients with possible myocarditis. This finding enhances risk stratification beyond traditional markers like ejection fraction and late gadolinium enhancement.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Myocardial Diseases

Background:

  • Left ventricular ejection fraction (LVEF) and cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) are established risk markers in myocarditis.
  • The prognostic value of atrial functional impairment in myocarditis is currently unknown.

Purpose of the Study:

  • To evaluate the association of left atrial (LA) and right atrial (RA) long axis shortening (LAS) assessed by CMR with major cardiovascular adverse events (MACE) in patients with possible myocarditis.

Main Methods:

  • Included 787 patients meeting 2025 European Society of Cardiology criteria for 'possible myocarditis' without coronary artery disease.
  • Assessed LA and RA long axis shortening (LAS) using CMR.
  • Associated LAS with a composite of first MACE, including heart failure hospitalization, sustained ventricular tachycardia, recurrent myocarditis, and all-cause mortality.

Main Results:

  • After a median follow-up of 3.5 years, 17.5% of patients experienced MACE.
  • Both LA-LAS and RA-LAS were independently associated with MACE in multivariable models.
  • Adding atrial LAS to a baseline model significantly improved risk stratification for MACE (C-index from 0.72 to 0.75).

Conclusions:

  • Atrial dysfunction, indicated by atrial LAS, is present in possible myocarditis.
  • Atrial LAS independently and incrementally predicts outcomes, offering added value beyond traditional CMR markers.
  • Atrial LAS may refine future risk stratification for patients with possible myocarditis.
Abstract

Keywords:
CMRMACEatrial functionatrial long axis atrial shorteningheart failuremyocarditis

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