Key result
CMR LA reservoir strain outperforms passive emptying fraction for distinguishing cardiomyopathies from healthy volunteers.
Why the study?
The study was conducted to compare the diagnostic accuracy of CMR-based left atrial volumetry and function, including LA strain analysis, for detecting myocardial impairments across diseases of different etiologies.
Does CMR-based left atrial strain analysis improve diagnostic accuracy for identifying cardiac diseases with overlapping phenotypes compared to traditional LA volumetry?
Cross-Sectional (n=190)
Does CMR-based left atrial strain analysis improve diagnostic accuracy for identifying cardiac diseases with overlapping phenotypes compared to traditional LA volumetry?
Effect estimate: AUC
Absolute Event Rate: 0.85% vs 0.78%
p-value: p=<0.05
CMR-based left atrial strain analysis outperforms traditional volumetric and functional assessments in distinguishing patients with cardiomyopathies from healthy volunteers.
May aid CMR differentiation of cardiomyopathies; leaves open prospective validation versus volumetry in overlapping phenotypes.
BACKGROUND: The main objective of this study was to compare diagnostic accuracies of cardiac magnetic resonance (CMR)-based left atrial (LA) volumetry and function, including LA strain analysis, for the detection of myocardial impairments in diseases of different etiologies such as hypertensive heart disease, Fabry disease and acute myocarditis. METHODS: Healthy volunteers (HV, n = 50) and patients with cardiomyopathies (n = 140), including patients with hypertensive heart disease (n = 40), Fabry disease (n = 49), and acute myocarditis (n = 51), underwent CMR at 3 T. Atrial volume and strain analysis based on long-axis cine acquisition was performed using a commercially available post-processing software. RESULTS: Patients exhibited impaired LA reservoir (28.60 ± 9.91 % vs. 41.27 ± 7.54 %), conduit (17.35 ± 7.72 % vs. 26.89 ± 5.25 %) and booster strain (11.30 ± 4.52 % vs. 14.61 ± 4.15 %) parameters compared to HV (all p < 0.001). In contrast, the volumetric values showed no significant difference between patients and HV (p > 0.05). Passive and total emptying fractions were significantly lower in patients (p < 0.001), while active emptying fraction did not differ (p > 0.05). Superior diagnostic accuracy for the LA reservoir strain demonstrated improved prognostic performance comparing to LA volumetric and functional parameters (area under the curve [AUC] 0.85 vs. e.g. passive emptying fraction AUC 0.78, p < 0.05). CONCLUSION: LA strain parameters effectively distinguish patients with cardiac diseases presenting overlapping phenotypes from HV and outperform volumetric and traditional functional assessments of the LA.
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Reichardt et al. (2025) conducted a cross-sectional in Cardiomyopathies (n=190). CMR-based left atrial strain analysis vs. LA volumetric and functional parameters was evaluated on Diagnostic accuracy (AUC) for detecting myocardial impairments (AUC, p=<0.05). CMR-based left atrial reservoir strain showed superior diagnostic accuracy over passive emptying fraction for distinguishing cardiomyopathies from healthy volunteers (AUC 0.85 vs 0.78, p<0.05).
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