References Values for Left Atrial Volumes, Emptying Fractions, Strains, and Strain Rates and Their Determinants by Age, Gender, and Ethnicity: The Multiethnic Study of Atherosclerosis (MESA)

Vasconcellos, Henrique Doria De; Win, Theingi Tiffany; Chamera, Ela; Hong, Seo Young; Ambale-Venkatesh, Bharath; Young, Patrick; Yang, Xinmi; Ciuffo, Luisa; Sharma, Ravi; Imai, Masamichi; Habibi, Mehdi; Wud, Colin O.; Heckbert, Susan R.; Bluemke, David A.; Lima, João A.C.

doi:10.1016/j.acra.2020.02.010

Cited by 19 publications

(17 citation statements)

References 42 publications

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“…Race has been shown to be an independent factor affecting LA volumes and function in the multiethnic study of atherosclerosis, as demonstrated by the lower LA phasic volumes and higher LA function in Chinese‐Americans compared with Whites 11 . In comparison to a recent MR‐FT study based on healthy Caucasians by Truong et al, 13 LA reservoir and conduit strain presented in this study were comparable.…”

Section: Discussionsupporting

confidence: 60%

“…Knowledge of normal reference values is essential for interpreting abnormal cardiac conditions. Evidence is available that there are significant racial differences in LA structure and function, 11,12 emphasizing the necessity of the establishment of ethnic‐specific normal values for LA measurements. Although some studies have determined normal values of LA strain and SR for Western populations, 13,14 MR reference values of LA deformation parameters for healthy Asian populations have not been well established.…”

Section: Introductionmentioning

confidence: 99%

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

Gao

Zhang

et al. 2021

Magnetic Resonance Imaging

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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

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

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

Gao

Zhang

et al. 2021

Magnetic Resonance Imaging

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“…Multimodality tissue tracking software (MTT version 6.0, Toshiba Medical Systems Corporation, Tokyo, Japan) was used to quantify LA volume and strain from 2-and 4-chamber cine CMR images (Supplementary File 2). This method has been validated previously with good to excellent intra-and interreader reproducibility with intraclass correlation (ICC) of 0.88 to 0.98 (p < 0.001), and good inter-study reproducibility with ICC of 0.44 to 0.82 (p < 0.05 to 0.001) (24)(25)(26). A single experienced operator, blinded to the participant's case status, defined endocardial and epicardial borders of the LA at endsystole.…”

Section: Cmr Protocol and Image Analysismentioning

confidence: 99%

Left Atrioventricular Coupling Index to Predict Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis

Pezel

Venkatesh

Kato

et al. 2021

Front. Cardiovasc. Med.

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Background: Although left atrial (LA) and left ventricular (LV) structural and functional parameters have independent prognostic value as predictors of heart failure (HF), the close physiological relationship between the LA and LV suggest that the assessment of LA/LV coupling could better reflect left atrioventricular dysfunction and be a better predictor of HF.Aim: We investigated the prognostic value of a left atrioventricular coupling index (LACI), measured by cardiovascular magnetic resonance (CMR), as well as change in LACI to predict incident HF in the Multi-Ethnic Study of Atherosclerosis (MESA).Materials and Methods: In the MESA, 2,250 study participants, free of clinically recognized HF and cardiovascular disease (CVD) at baseline, had LACI assessed by CMR imaging at baseline (Exam 1, 2000–2002), and 10 years later (Exam 5, 2010–2012). Left atrioventricular coupling index was defined as the ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox proportional hazard models were used to evaluate the associations of LACI and average annualized change in LACI (ΔLACI) with incident HF after adjustment for traditional MESA-HF risk factors. The incremental risk prediction was calculated using C-statistic, categorical net reclassification index (NRI) and integrative discrimination index (IDI).Results: Among the 2,250 participants (mean age 59.3 ± 9.3 years and 47.6% male participants), 50 incident HF events occurred over 6.8 ± 1.3 years after the second CMR exam. After adjustment, greater LACI and ΔLACI were independently associated with HF (adjusted HR 1.44, 95% CI [1.25–1.66] and adjusted HR 1.55, 95% CI [1.30–1.85], respectively; both p < 0.0001). Adjusted models for LACI showed significant improvement in model discrimination and reclassification compared to currently used HF risk score model for predicting HF incidence (C-statistic: 0.81 vs. 0.77; NRI = 0.411; IDI = 0.043). After adjustment, ΔLACI showed also significant improvement in model discrimination compared to the multivariable model with traditional MESA-HF risk factors for predicting incident HF (C-statistic: 0.82 vs. 0.77; NRI = 0.491; IDI = 0.058).Conclusions: In a multi-ethnic population, atrioventricular coupling (LACI), and coupling change (ΔLACI) are independently associated with incident HF. Both have incremental prognostic value for predicting HF events over traditional HF risk factors.

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“…Table illustrates normal ranges by TTE vs CMR for: LAS_r = LA strain at reservoir, LAS_cd = LA strain at conduit, LAS_bp = LA strain at booster-pump phase. Normal ranges from[ 64 , 68 , 105 , 106 ]. The graph illustrates the change in LA strain during the cardiac cycle …”

Section: Reference Values In Healthy Adultsmentioning

confidence: 99%

Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease

Alfuhied

Kanagala

McCann

et al. 2021

Int J Cardiovasc Imaging

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The left atrium (LA) plays a vital role in maintaining normal cardiac function. LA volume and function have been utilised as important imaging biomarkers, with their prognostic value demonstrated in multiple cardiac conditions. More recently, there has been a sharp increase in the number of publications utilising LA strain by echocardiography and cardiac magnetic resonance (CMR) imaging. However, little is known about its prognostic value or reproducibility as a technique. In this review, we aim to highlight the conventional and novel imaging techniques available for LA assessment, using echocardiography and CMR, their role as an imaging biomarker in cardiovascular disease, the reproducibility of the techniques and the current limitations to their clinical application. We identify a need for further standardisation of techniques, with establishment of ‘normal’ cut-offs before routine clinical application can be made.

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References Values for Left Atrial Volumes, Emptying Fractions, Strains, and Strain Rates and Their Determinants by Age, Gender, and Ethnicity: The Multiethnic Study of Atherosclerosis (MESA)

Cited by 19 publications

References 42 publications

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

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

Left Atrioventricular Coupling Index to Predict Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis

Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease

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