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Updated: Aug 6, 2026

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

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Published on: July 20, 2022

Influence of left bundle branch block on left atrial strain parameters in patients with ischaemic and non-ischaemic

Antonia Petersen1, P Kamieniarz2, D Meteva3

  • 1Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. antonia.petersen@charite.de.

The International Journal of Cardiovascular Imaging
|July 21, 2026
PubMed

Insights

Left bundle branch block (LBBB) does not worsen left atrial (LA) strain in dilated cardiomyopathy (DCM) patients. LA strain remains a robust measure of heart function even with LBBB, though LA conduit strain rate is impaired in LBBB without DCM.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiac Physiology

Background:

  • Left atrial (LA) strain parameters are crucial predictors of mortality in dilated cardiomyopathy (DCM).
  • Left bundle branch block (LBBB) is a frequent comorbidity in DCM patients.
  • The specific impact of LBBB on LA strain, particularly when assessed via cardiovascular magnetic resonance imaging (cMRI), remains under-investigated.

Purpose of the Study:

  • To systematically evaluate the effect of LBBB on LA strain parameters in patients with and without DCM using cMRI.
  • To determine if LBBB exacerbates LA functional deficits in DCM patients.
  • To assess the robustness of LA strain parameters in the presence of LBBB.

Main Methods:

  • Retrospective single-centre study including controls, patients with LBBB, patients with DCM, and patients with both DCM and LBBB.
  • Semi-automated assessment of LA volumes and strain parameters using cvi42® and Segment® software.
  • Comparison of LA reservoir/conduit strain and strain rates across the four study groups.

Main Results:

  • DCM significantly impaired LA reservoir/conduit strain and strain rates compared to controls.
  • LBBB did not significantly alter LA reservoir/conduit strain or strain rates in controls or DCM patients.
  • LA conduit strain rate was significantly impaired in patients with LBBB compared to controls, irrespective of DCM.
  • Left ventricular dilatation was associated with impaired LA strain and strain rates.

Conclusions:

  • LBBB does not add significant impairment to LA strain parameters in DCM patients, highlighting the resilience of these measures.
  • LA conduit strain rate impairment in LBBB patients without DCM warrants further investigation.
  • LA strain assessment remains valuable for evaluating cardiac function in DCM, even with co-existing LBBB.

Keywords:
Cardiac magnetic resonance imagingDilated cardiomyopathyLeft atrial strainLeft bundle branch block

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