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

Jie Hou; Yu Sun; Libo Zhang; Wei Wang; Hongrui You; Rongrong Zhang; Benqiang Yang; Huishan Wang

doi:10.1002/clc.23811

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

Clin Cardiol. 2022 May;45(5):527-535. doi: 10.1002/clc.23811. Epub 2022 Mar 15.

Authors

Jie Hou^{1

2

3}, Yu Sun^{1

2

3}, Libo Zhang^{2

3}, Wei Wang^{2

3}, Hongrui You^{2

3}, Rongrong Zhang^{2

3}, Benqiang Yang^{2

3}, Huishan Wang⁴

Affiliations

¹ College of Medical and Biological Informatics Engineering, Northeastern University, Shenyang, China.
² Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.
³ Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China.
⁴ Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China.

Abstract

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.

Keywords: atrial fibrillation; cardiovascular magnetic resonance imaging; feature tracking; left atrial function; strain; valvular heart disease.

MeSH terms

Atrial Fibrillation* / complications
Atrial Fibrillation* / diagnosis
Atrial Function, Left / physiology
Cross-Sectional Studies
Heart Atria / diagnostic imaging
Heart Valve Diseases* / diagnosis
Heart Valve Diseases* / diagnostic imaging
Humans
Magnetic Resonance Imaging / methods
Reproducibility of Results
Retrospective Studies

Abstract

MeSH terms

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