Key result
LA-GLS strongly correlates with LV longitudinal function in patients with and without LV dysfunction.
Why the study?
The degree to which LA strain is affected or determined by LV longitudinal function in LV dysfunction had been explored by echocardiography, but not by CMR.
Is left atrial reservoir strain associated with left ventricular longitudinal function in patients with left ventricular dysfunction?
Is left atrial reservoir strain associated with left ventricular longitudinal function in patients with left ventricular dysfunction?
Left atrial reservoir function is largely determined by left ventricular longitudinal function in patients with LV dysfunction, suggesting it may not be an independent marker of global cardiac function in this population.
LA-GLS may not be independent of LV function in LV dysfunction; cross-sectional data leaves open its incremental prognostic value.
Aims Left ventricular (LV) longitudinal function is a prognostic marker of hospitalization and mortality in LV dysfunction. Recently, left atrial (LA) reservoir and conduit strain have also been presented as independent prognostic markers. However, the atria and ventricles are coupled in the fibrous atrioventricular plane (LA-LV coupling). The degree to which LA strain is affected, or even determined, by the LV longitudinal function in LV dysfunction has been explored by echocardiography, but not by CMR. Therefore, we aimed to quantify the association between LV longitudinal ventricular function and LA strain using CMR feature-tracking. Methods Three hundred and forty-two patients with LV dysfunction (including heart failure with reduced ejection fraction (HFrEF), candidates for cardiac resynchronization therapy (CRT) implantation, and ischemic heart disease (IHD)), and 19 healthy controls (HC) who had undergone cardiac magnetic resonance imaging (CMR) were retrospectively included. LV global longitudinal strain (LV-GLS), LV atrioventricular plane displacement (AVPD), and LA-GLS (i.e. reservoir strain) were analyzed in long-axis views using CMR feature-tracking. Results LA-GLS was lower in the LV dysfunction group when compared to HC (12±8% vs 19±7, p<0.001), mirroring reductions in LV-GLS (-10±5% vs -19±3, p<0.001) and LV-AVPD (9±3 mm vs 15±2 mm, p<0.001). The coefficient of determination (r2) between LV-GLS and LA-GLS was for the whole cohort 0.40 (95% CI 0.32–0.48), and 0.39 (95% CI 0.31–0.47) between LV-AVPD and LA-GLS. Conclusions In a large cohort comprising both patients with LV dysfunction and HC, LA reservoir function quantified as LA-GLS was to a large extent determined by LV longitudinal function. LA function may not be an independent marker of global cardiac function for certain patient groups where diminished LA function can be a reflection of LV dysfunction.
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Östenson et al. (2026) studied this question.
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