Related Experiment Video
Updated: Oct 28, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Integrated Atrial Mechanics-Biomarker Profiling Predicts Left Ventricular Ejection Fraction Improvement in Heart
Federico García-Rodeja Arias1,2,3,4,5, Sonia Eiras6,7, Alberto Cordero7,8
1Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain. fedeg-r@hotmail.com.
Abstract:
Improvement of left ventricular ejection fraction (LVEF) is a relevant phenotype in heart failure with reduced ejection fraction (HFrEF), but its substrate remains unclear. In 175 HFrEF patients followed prospectively for 24 months with serial echocardiography, left atrial (LA) strain and 16 biomarkers, LVEF improvement (increase ≥ 10 points to > 40%) occurred in 80 patients (45.7%). Improvers were more often women and non-ischaemic, with smaller LV volumes, better LV longitudinal strain, shorter atrial conduction time and lower ANP, relaxin-2 and COL4A1; baseline LA volume and strain did not differ. An exploratory eight-variable model had apparent and optimism-corrected AUCs of 0.93 and 0.84. NT-proBNP and LA reservoir strain diverged progressively between groups. Improvement was associated with lower mortality (HR 0.25; 95% CI 0.08-0.75) and fewer heart failure hospitalisations (HR 0.38; 95% CI 0.18-0.78). LVEF improvement reflects progressive atrial and neurohormonal reverse remodelling rather than favourable baseline atrial mechanics.
