Preliminary Study of CMR Combined with Myocardial Strain Imaging for Left Atrial Fibrosis Assessment in Atrial Fibrillation Patients

Motivation: Left atrial (LA) function and structural remodeling in atrial fibrillation (AF) remains uncertain in the context of LA-CMR. Goal(s): To investigate the effectiveness of 3D-LGE CMR and LA-strain techniques for assessing LA fibrosis in paroxysmal or persistent AF (PaAF, PeAF) patients. Approach: Preoperative CMR was used to analyze LA-strain parameters. Quantitative assessments of LA wall enhancement utilized the Infarct-to-Interstitial Ratio (IIR) as a reference. Results: Contrasted with PaAF, those with PeAF exhibited increased LA volumes, reduced LA function, and lower strain values. In 3D-LGE sequences, PeAF patients demonstrated more extensive myocardial enhancement, scar tissue, and interstitial fibrosis in comparison to PaAF patients. Impact: Our research provides a promising imaging tool for the management of AF patients, with potential translational applications focused on quantitatively and visually assessing LA function and structural remodeling, personalizing treatment, assisting intraoperative navigation, and enabling long-term monitoring.