Novel Insights into Left Atrial Mechanics: Prognostic Value of Left Atrial Contractile Index in Heart Failure with Preserved Ejection Fraction

Motivation: LA booster function plays a critical role in the progression of HFpEF. Goal(s): To evaluate the prognostic value of a novel strain-derived index —LA contractile index in patients with HFpEF. Approach: This retrospective study included 803 patients. The primary endpoint was a composite of cardiovascular death and HF hospitalization. LA contractile index was calculated as the percentage of booster strain relative to reservoir strain. Results: Over a median follow-up of 7.3 years, the abnormal LA contractile index was independently associated with the primary endpoint. The models incorporating clinical, conventional imaging variables, and LA contractile index exhibited the highest calibration. Impact: A novel index derived from CMR-FT —LA contractile index shows its potential as a robust predictor of adverse outcomes in patients with HFpEF, providing novel insights into the pathophysiology and prognostication of this condition.