Reproducibility of left atrial function using cardiac magnetic resonance imaging

Alfuhied, Aseel; Marrow, Benjamin A.; Elfawal, Sara; Gulsin, Gaurav S; Graham-Brown, Matthew P M; Steadman, Christopher D; Kanagala, Prathap; McCann, Gerry P; Singh, Anvesha

doi:10.1007/s00330-020-07399-z

Cited by 25 publications

(20 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies evaluating the test–retest reproducibility of LA assessment have been limited and with small sample sizes (n = 12–22) and mainly in healthy volunteers [ 40 , 67 , 100 , 101 ] (Table 4 ). However, a recent study including subjects with and without cardiovascular disease (n = 60) showed LAEF to have better test–retest reproducibility than LA strain, whilst reservoir strain accounted for the most reproducible strain parameter [ 102 ].…”

Section: Reproducibility Of Techniquesmentioning

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

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Reproducibility Of Techniquesmentioning

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

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our study showed the same results. However, Alfuhied A et al 40 found that sixty participants including 16 aortic stenosis, 28 type 2 diabetes, 10 end‐stage renal disease on hemodialysis, and 10 healthy volunteers underwent CMR scans, the result showed that LA strain and strain rate assessment using CMR‐FT showed moderate to poor test–retest reproducibility across disease states, LAV and emptying fraction showed more reproducible on CMR. It may be related to the small number and heterogeneous of disease in each group.…”

Section: Discussionmentioning

confidence: 99%

Assessing left atrial function in patients with atrial fibrillation and valvular heart disease using cardiovascular magnetic resonance imaging

Hou

Sun

Zhang

et al. 2022

Clinical Cardiology

View full text Add to dashboard Cite

Background Atrial fibrillation (AF) is common arrhythmia in valvular heart disease (VHD) and is associated with adverse outcomes. Hypothesis To evaluate the left atrial (LA) function in patients with AF‐VHD by cardiovascular magnetic resonance imaging feature tracking (CMR‐FT) using LA strain ( ε s / ε e / ε a ) and their corresponding strain rate (SRs/SRe/SRa). Methods This was a retrospective cross‐sectional inter‐reader and intra‐reader reproducibility conducted from July 1, 2020, to January 31, 2021. A total of 39 patients with AF‐VHD (rheumatic heart valvular disease [RHVD] [ n = 22], degenerative heart valvular disease [DHVD] [ n = 17]) underwent MRI scans performed with drug‐controlled heart rate before correcting the rhythm and valves through maze procedure. Fifteen participants with normal cardiac MRI were included as healthy control. ε s /SRs, ε e /SRe, and ε a /SRa, corresponding to LA reservoir, conduit, and booster‐pump function, were assessed using Feature Tracking software (CVI42 v5.12.1). Results Compared with healthy controls, LA global strain parameters ( ε s / ε e / ε a /SRs/SRe/SRa) were significantly decreased (all p < 0.001), while LA size and volume were increased in AF‐VHD group (all p < 0.001). In the subgroup, RHVD group showed lower LA total ejection fraction (LATEF) and strain data than DHVD group (12.6% ± 3.3% vs. 19.4 ± 8.6, p = 0.001). Decreased LATEF was significantly related to altered LA strain and strain rate, especially in ε s , ε e , and SRs (Pearson/Spearman r/ρ = 0.856/0.837/0.562, respectively; all p < 0.001). Interstudy and intrastudy reproducibility were consistent for LA volumetry and strain parameters (intraclass correlation coefficient: 0.88–0.99). Conclusions CMR‐FT can be used to assess the LA strain parameters, and identify LA dysfunction and deformation noninvasively, which could be a helpful functional imaging biomarker in the clinical treatment of AF‐VHD.

show abstract

“…Additionally, Ferreira et al have shown that defective LA emptying fraction was a strong predictor for all-cause mortality [35].As for LA strain, studies have shown that LA strain was related to LV dysfunction and AS severity, being also an independent predictor for HF hospitalization, all-cause mortality, and new-onset atrial brillation, regardless of LA dilation [36,37]. Recently, Kim et al have conducted a CMR study in which they have suggested that LA peak longitudinal strain might predict cardiovascular events in AS [38], but several studies have shown that traditional CMR methods might have questionable reliability, requiring further adjustments [39]. Taken together, more work is still required to properly assess the prognosis ability of CMR-based LA parameters.…”

Section: Discussionmentioning

confidence: 99%

Quantification of left atrial function and geometry by cardiac magnetic resonance imaging in patients with severe aortic stenosis

Cionca

Zlibut

Orzan

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose: The study sought to evaluate the role of CMR in characterizing LA geometry and function in patients with severe aortic stenosis (AS). Left atrial (LA) enlargement and dysfunction are closely related to AS progression, however, a CMR-based approach has not been yet appraised.Method: We prospectively evaluated 70 patients with severe AS and 70 age and gender-matched healthy volunteers. LA morphology, function and geometry were determined using CMR. A composite outcome (cardiac death, ventricular tachyarrhythmias, and heart failure hospitalization) was evaluated over a median of 31 months. Time-to-event outcomes were analyzed using Kaplan-Meier method.Results: LA volumes (LAV) were significantly increased, and LA sphericity index (LASI) was decreased (all p<.001), while LA phasic functions and strains were also considerably defective in patients with AS (all p<.001). Moreover, LA volumes were closely associated with LA atrial booster function and LA strains (all p<.0001), while LASI mostly related to LA total and active strain (p<.0001). Furthermore, LV mass (LVM), end-diastolic (LVEDV) and end-systolic volumes (LVESV) were significantly associated with all LA strains (p<.0001). In prognosis prediction, LA total (LA-et), passive (LA-ep) and active (LA-ea) strain, along with LASI were independently associated with increased risk of outcome (p<.001). Time-to-event analysis showed significantly higher risk to reach the composite outcome for LA-et>31.1 ml/m2 [HR=5.94; p=.0002)], LA-ep >14.5% [HR=4.04; p<.0009)], LA-ea<21.2% [HR=2.25; p<.04], LASI>0.5 [HR=2.24; p<.04)].Conclusion: Patients with severe AS and impaired LA geometry and function at CMR have increased risk of outcomes. LAVmin, LASI, LAPF and LA-ep were independent predictors for outcome.

show abstract

Reproducibility of left atrial function using cardiac magnetic resonance imaging

Cited by 25 publications

References 46 publications

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

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

Assessing left atrial function in patients with atrial fibrillation and valvular heart disease using cardiovascular magnetic resonance imaging

Quantification of left atrial function and geometry by cardiac magnetic resonance imaging in patients with severe aortic stenosis

Contact Info

Product

Resources

About