Related Experiment Video
Updated: Aug 19, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Predicting Atrial Fibrillation Risk in Hypertrophic Cardiomyopathy Patients: Left Atrial Phasic Function and Strain
Mahdi Montazeri1, Negin Rashidi1, Deacon Z J Lee1
1Division of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada.
Insights
Left atrial function, measured by cardiovascular magnetic resonance, predicts atrial fibrillation in hypertrophic cardiomyopathy patients. Reduced LA strain and ejection fraction indicate higher AF risk.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart condition.
- Atrial fibrillation (AF) is a common complication in HCM patients.
- Early detection of AF risk in HCM is crucial for management.
Purpose of the Study:
- To investigate if left atrial (LA) function and myocardial deformation, assessed by cardiovascular magnetic resonance (CMR), predict AF development in HCM patients.
- To identify specific LA parameters that correlate with AF incidence in this population.
Main Methods:
- A case-control study comparing HCM patients who developed AF (n=140) with those who did not (n=70).
- Baseline CMR imaging was used to evaluate LA phasic function and myocardial deformation.
- Univariate and multivariable Cox proportional hazards models analyzed the correlation between clinical and imaging parameters and AF development.
Main Results:
- HCM patients who developed AF had significantly larger baseline LA volumes and reduced LA strain and strain rates compared to the non-AF group.
- Specifically, LA booster strain and total LA ejection fraction were significantly worse in the AF group (P < 0.00001).
- Left ventricular (LV) parameters like wall thickness and mass were higher in the AF group, but LV ejection fraction and late gadolinium enhancement were similar.
Conclusions:
- Baseline LA booster strain and total LA ejection fraction assessed by CMR are significant predictors of AF development in HCM patients.
- These LA functional parameters offer valuable insights into AF risk stratification in HCM.
- LV disease burden markers did not show a significant relationship with AF development in this cohort.
Background:
To evaluate whether the left atrium (LA) phasic function and myocardial deformation by cardiovascular magnetic resonance (CMR) in hypertrophic cardiomyopathy (HCM) patients is a predictor of atrial fibrillation (AF) development.
Methods:
The baseline CMRs of HCM patients who later developed AF (n = 140; mean age = 61 ± 12 years; male = 86) were compared with those of HCM patients who did not develop AF (n = 70; mean ag e= 58 ± 11 years; male patients = 48). This case-control study was conducted at our quaternary referral centre between January 2001 and June 2021. The univariate and multivariable Cox proportional hazards model was used to assess the correlation between clinical and imaging parameters vs the likelihood of developing AF.
Results:
Compared to the non-AF cohort, HCM patients with AF had larger baseline LA volumes and lower LA strain and LA strain rates. Maximum left ventricular (LV) wall thickness, absolute and indexed LV mass, and indexed LV end-diastolic volume were larger in patients with AF vs the non-AF group. LV ejection fraction assessed by CMR along with late gadolinium enhancement prevalence and pattern was similar between patients with vs without AF.LA booster strain (5.8 ± 3.4 in the AF group vs 11.4 ± 4.2 in the non-AF group, P < 0.00001) and total LA ejection fraction (32.9 ± 12.8 in the AF group vs 44.0 ± 9.3 in the non-AF group, P < 0.00001) were significantly worse at baseline in the AF group. No significant relationship was present between markers of LV disease burden and AF.
Conclusions:
LA booster strain and total LA ejection fraction at baseline CMR correlated with AF development in HCM patients.
