What question did this study set out to answer?

This study evaluates the ability of cardiac MRI-derived left atrial strain to predict atrial fibrillation in patients with transthyretin cardiac amyloidosis.

June 27, 2026EP EuropaceOpen Access

CMR-derived left atrial strain predicts incident atrial fibrillation in transthyretin cardiac amyloidosis

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Why the study?

Patients with ATTR-CM are at high risk for AF, and CMR-derived left atrial strain parameters may help identify at-risk patients before clinical AF onset.

Do CMR-derived left atrial strain parameters predict incident atrial fibrillation in patients with transthyretin cardiac amyloidosis?

Population

86 patients with ATTR-CM and no prior AF

Comparison

Highest strain quartile (Q1) vs combined lower three quartiles (Q2-Q4)

Design

Retrospective cohort study

Follow-up

Median 26.6 months

Authors

PLP LustigMedical University of Vienna LSL SchmidMedical University of Vienna MPM PoledniczekMedical University of Vienna

Discussion

Member takes

Implication

LA strain parameters associated with incident AF; hypothesis-generating for risk stratification, needs prospective validation.

Key Points

This study evaluates the ability of cardiac MRI-derived left atrial strain to predict atrial fibrillation in patients with transthyretin cardiac amyloidosis.
Retrospective analysis of 86 ATTR-CM patients without prior AF who underwent CMR and LA strain analysis.
Kaplan-Meier survival analyses compared AF-free survival based on LA strain quartiles.
Cox regression models assessed the association between LA strain parameters and AF onset.
During 26.6 months follow-up, 37 (43%) patients developed AF, with significantly lower AF-free survival in lower strain quartiles (p < 0.006).
LA conduit strain showed a strong association (HR 0.715, 95% CI 0.596–0.856) with the onset of AF.
ROC analysis confirmed discriminative ability of LA strain parameters; conduit and reservoir strain performed best (AUC 0.724 and 0.722).

Structured PICO

Do CMR-derived left atrial strain parameters predict incident atrial fibrillation in patients with transthyretin cardiac amyloidosis?

Population

86 patients with transthyretin cardiac amyloidosis (ATTR-CM) and no prior atrial fibrillation, median age 77 years, 80% male.

Intervention

CMR-derived left atrial (LA) strain assessment (peak global longitudinal strain, reservoir strain, conduit strain, booster strain, and peak global radial strain)

Comparator

Highest respective strain quartile (Q1, best strain) compared to the combined lower three quartiles (Q2-Q4)

Outcome

Incident atrial fibrillation (AF) during follow-uphard clinical

CMR-derived left atrial strain parameters, particularly reservoir and conduit strain, independently predict incident atrial fibrillation in patients with ATTR-CM, potentially guiding early surveillance.

Cite This Study

Lustig et al. (2026) studied this question.

synapsesocial.com/papers/6a3f97ce125782b61d8659ea https://doi.org/10.1093/europace/euag105.337

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CMR-derived left atrial strain predicts incident atrial fibrillation in transthyretin cardiac amyloidosis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

CMR-derived left atrial strain predicts incident atrial fibrillation in transthyretin cardiac amyloidosis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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