Key result
In healthy volunteers, restricting the analysis to a heart rate of 60-75 beats per minute eliminated gender differences in left atrial reservoir, conduit, and booster strains.
Why the study?
Data on normal left-atrial strain assessed by feature-tracking CMR remain limited, prompting investigation into the value of multi-parametric regression analyses and the influence of heart rate.
Cross-Sectional (n=183)
No
Absolute Event Rate: 49.2% vs 44.9%
p-value: p=0.079
Heart rate selection (60-75 bpm) eliminates previously observed gender differences in normal left atrial strain assessed by CMR, highlighting the importance of heart rate in multiparametric strain analyses.
Heart rate standardization may eliminate apparent gender differences in left atrial strains; hypothesis-generating, should not yet change practice.
Left-atrial (LA) strain is the result of complex hemodynamics, increasingly assessed by feature-tracking cardiovascular magnetic resonance (CMR). We investigate the value of multi-parametric regression (MPR) analyses and the influence of the heart rate on LA-strain. As LA-strain data remains limited, CMR-quantified sex- and age-dependent normal values were derived. After following a health assessment questionnaire, 183 healthy volunteers (11-70 years, 97 females, median 32.9±28.3 years) were recruited for LA-strain assessment. LA volumetric data, left ventricular strain, transmitral and pulmonary venous blood flow parameters were utilized to create clusters for MPR analyses for all subjects and heart rate-specific subgroups (range: 60–75 beats-per-minute, N=106). In comparison to the total cohort, subgroups showed no gender differences (p>0.05) for LA reservoir, conduit and booster strains (all: 47.3±12.7%; 29.0±15.5%; 17.6±5.4%) and strain rates (all: 2.1±1.0 s −1 ; -2.9 ± 1.5 s −1 ; -2.3 ± 1.0 s −1 ). MPR analyses identified parameter clusters with large effect size (|R²|≥0.26) for reservoir-, conduit- and booster strain and corresponding active and passive cardiac functional parameters. Increased correlations for the subgroup were found. In contrast to previous studies, heart rate selected subgroups showed no gender differences in LA-strain. MPR analyses improve characterization of LA-strain at selected heart rates.
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Eckstein et al. (2022) conducted a cross-sectional in Healthy (n=183). Heart rate 60-75 bpm vs. Unrestricted heart rate was evaluated on Left atrial reservoir strain in the heart rate-restricted subgroup (60-75 bpm) by gender (p=0.079). In healthy volunteers, restricting the analysis to a heart rate of 60-75 beats per minute eliminated gender differences in left atrial reservoir, conduit, and booster strains.
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