Reference Values for Left Atrial Strain and Strain Rate Based on a Large Sample of Healthy Chinese Adults: An MR‐Feature Tracking Study

Abstract

Background While reference values of left atrial (LA) deformation parameters in Western populations have been established, reference data in healthy Asian populations are limited. Purpose To establish age‐ and sex‐specific reference values for LA strain and strain rate (SR) based on a large sample of healthy Chinese adults using magnetic resonance‐feature tracking (MR‐FT). Study Type Retrospective. Population Four hundred and eight healthy Chinese adults (220 males, aged 43.5 ± 11.5 years; 188 females, aged 45.3 ± 12.8 years). Field Strength/Sequence 1.5 T/balanced steady‐state free precession. Assessment Reservoir strain (εs), conduit strain (εe), booster strain (εa), peak positive SR (SRs), peak early negative SR (SRe), and peak late negative SR (SRa) were obtained by MR‐FT. Statistical Tests We used Shapiro–Wilk test, Student's t‐test, Mann–Whitney U‐test, linear regression, and coefficient of determination (r2). Results Women demonstrated significantly greater LA strain (εs [%]: 44.0 ± 9.9 vs. 38.3 ± 8.7; εe [%]: 26.7 ± 8.0 vs. 22.3 ± 6.8; εa [%]: 17.3 ± 4.4 vs. 16.0 ± 3.8) and SR (SRs [/second]: 1.8 ± 0.5 vs. 1.6 ± 0.4; SRe [/second]: −2.5 ± 0.9 vs. −2.1 ± 0.7; SRa [/second]: −1.9 ± 0.6 vs. −1.8 ± 0.5) than men. For both sexes, aging was significantly associated with decreased εs, SRs, εe, and SRe (r2 = 0.07, r2 = 0.05, r2 = 0.19, and r2 = 0.24 for men; r2 = 0.13, r2 = 0.11, r2 = 0.31, and r2 = 0.46 for women), and significantly increased εa (r2 = 0.03 and r2 = 0.05 for men and women). There was no significant correlation between age and SRa in both sexes (P = 0.057 and P = 0.377 for men and women, respectively). Data Conclusion We provide age‐ and sex‐specific reference values for LA strain and SR based on a large sample of healthy Chinese adults using MR‐FT. Level of Evidence 3 Technical Efficacy Stage 5

Sex-Related Differences of Left Atrial Strain in Patients With Hypertension Using Cardiac Magnetic Resonance Feature Tracking

“…30 However, previous studies about the effect of sex on LA strain parameters were not always consistent. Gao et al 12 found that women had higher magnitudes of LA strain and strain rate than men in a cohort of healthy Chinese adults, Liao et al 31 also reached a similar conclusion with a large Asian population. Truong et al 32 demonstrated that LA strain and strain rate were similar between both genders using CMR-FT. Age, sample size, and race may together partially explain the inconsistency of our results with previous studies.…”

“…7 Although both men and women have similar mechanisms that regulate arterial blood pressure, sex-specific differences indeed exist in prevalence and treatment response following cardiovascular adverse events. 8 Previous studies have demonstrated the influence of sex on LV strain in a healthy population free of cardiovascular disease and patients with hypertension by cardiac magnetic resonance feature tracking (CMR-FT) [9][10][11] and also observed that women had a significantly higher LA strain and strain rate than men based on a large sample of healthy Chinese adults using CMR-FT, 12 whereas study on the sex-related differences of LA strain in hypertension is scarce and the potential mechanism remains unclear. The CMR-FT technique, with better spatial resolution and reproducibility, has been increasingly recognized as an accurate and feasible technique for evaluating LA strain and strain rate, superior to speckle tracking echocardiography.…”

Association of sodium intake with adverse left atrial function and left atrioventricular coupling in Chinese

“…Stability and repeatability are advantageous [ 11 ]. More crucially, several CMR-FT investigations [ 12 , 13 ] on LA strain and strain rate (SR) have demonstrated high inter-and intraobserver repeatability.…”