January 10, 2026Applied Sciences0 citationsOpen Access
Left Atrial 4D Flow Characteristics in Patients with Atrial Fibrillation: Comparison with Healthy Controls and Associations with Left Atrial Remodelling and Contractile Health
Key Result
In patients with atrial fibrillation, LA stasis was greater on 4D flow compared to healthy volunteers, median 45.0% vs 34.5%, p = 0.040.
Key Points
- To examine flow alterations in patients with atrial fibrillation and their relationship with left atrial remodelling and contractility.
- Analyzed 4D flow characteristics in 57 atrial fibrillation patients undergoing pulmonary vein isolation and 12 healthy volunteers.
- Used magnetic resonance imaging to obtain left atrial velocity and stasis maps.
- Calculated left atrial volume, ejection fraction, and strain from cine images.
- AF patients exhibited greater left atrial stasis than healthy controls.
- A strong negative correlation was found between left atrial stasis and mean left atrial velocity in both cohorts.
- No association was found between left atrial stasis and markers of left atrial contractile function.
Structured PICO
Does left atrial 4D flow imaging identify differences in LA stasis and velocity between AF patients and healthy controls, and do these correlate with LA contractile function?
P
Population
57 consecutive patients with atrial fibrillation referred for magnetic resonance imaging before first-time pulmonary vein isolation (mean age 60 ± 9 years, 25% female) and 12 healthy volunteers (mean age 44 ± 15 years, 8% female).
I
Intervention
Left atrial four-dimensional (4D) flow magnetic resonance imaging
C
Comparator
Healthy volunteers (n=12)
O
Outcome
Left atrial flow characteristics (LA velocity and stasis maps) and their associations with LA remodelling and contractility markers (LA volume, ejection fraction, and strain)surrogate
4D flow MRI demonstrates increased left atrial stasis in AF patients compared to healthy controls, though this stasis does not correlate with traditional markers of LA contractile function.
Main Result
Absolute Event Rate: 0% vs 0%
Abstract
Left atrial (LA) four-dimensional (4D) flow quantification and strain may help predict stroke and thrombus formation in patients with atrial fibrillation (AF). We aimed to characterize flow changes in AF patients undergoing pulmonary vein isolation (PVI) and their associations with LA remodelling and contractility markers. Fifty-seven consecutive patients referred for magnetic resonance imaging before first-time PVI and twelve healthy volunteers (HV). LA velocity and stasis maps were obtained from 4D flow. Cine images were used for LA volume, ejection fraction, and strain. Patients’ age was 60 ± 9 years (25% female), versus 44 ± 15 years in HV (8% female). LA 4D flow markers showed LA stasis was reduced in AF patients (median Q1, Q3 45.0% (36.0, 54.0) vs. 34.5% (22.8, 45.3); p = 0.040). LA stasis and mean LA velocity were associated in AF patients (r = −0.52; p < 0.001) and HV (r = −0.9; p < 0.001). Associations were poorer for peak LA velocity in AF patients (r = −0.39; p = 0.003). LA stasis was not associated with any marker of LA contractile function in either the AF or HV cohorts. In conclusion, compared with HV patients, patients with AF showed greater LA stasis on 4D flow. LA stasis was not associated with markers of LA contractile function.