Key result
Isolated septal LGE is linked to ~2-point lower LA reservoir strain in dilated cardiomyopathy.
Why the study?
Are left ventricular late gadolinium enhancement location, extent, and pattern associated with left atrial phasic strain dysfunction in patients with dilated cardiomyopathy?
Cross-Sectional (n=816)
Investigators blinded to patient information
Yes
Are left ventricular late gadolinium enhancement location, extent, and pattern associated with left atrial phasic strain dysfunction in patients with dilated cardiomyopathy?
In patients with nonischemic dilated cardiomyopathy, left ventricular LGE location (specifically isolated septal fibrosis) is independently associated with impaired left atrial reservoir and booster strain, while LGE extent is associated with left atrial conduit strain.
Septal LGE may refine LA strain phenotyping in dilated cardiomyopathy; extends LGE markers but remains hypothesis-generating.
Background Left ventricular (LV) late gadolinium enhancement (LGE) characteristics are established prognostic markers in dilated cardiomyopathy (DCM), whereas their influence on left atrial (LA) function remains unclear. This study aimed to investigate the association between LGE characteristics and LA dysfunction in DCM using cardiac magnetic resonance (MR). Methods This retrospective study included 816 DCM patients who underwent cardiac MR between June 2010 and June 2024. LA reservoir, conduit, and booster strain were obtained using cardiac MR feature tracking (MR-FT). LGE location, extent, and pattern were assessed by LGE imaging. Data were analyzed using one-way analysis of variance and sequential multivariable regression models. Results LGE was present in 442 (54.2%) patients with DCM. LA strain parameters differed significantly across groups stratified by LGE location, extent, and pattern (all P < 0.05). After adjustment for clinical and cardiac MR parameters, LA reservoir, conduit, and booster strain were independently associated with LGE location [β coefficient = -2.097 (95% CI: -3.507, -0.686), -0.784 (95% CI: -1.490, -0.078), and − 1.313 (95% CI: -2.325, -0.300); all P < 0.05], while only conduit strain was associated with LGE extent [β coefficient = 0.675 (95% CI: 0.261, 1.089), P = 0.001]. After mutual adjustment for LGE location and extent, LGE location remained independently associated with LA reservoir strain [β = −1.957 (95% CI: -3.613, -0.301); P = 0.021] and booster strain [β = -1.698 (95% CI: -2.883, -0.514); P = 0.005], whereas LGE extent remained independently associated with LA conduit strain [β = 0.596 (95% CI: 0.111, 1.081); P = 0.016]. No consistent independent association was observed between LA strain parameters and LGE pattern. Conclusions In DCM, LGE location and extent showed distinct associations with LA phasic mechanics. LGE location was consistently associated with impaired LA reservoir strain, whereas LGE extent was associated with LA conduit strain. No consistent independent association was observed for LGE pattern.
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Gao et al. (2026) conducted a cross-sectional in Dilated cardiomyopathy (n=816). Isolated septal late gadolinium enhancement (LGE) location vs. Non-septal-only LGE distributions was evaluated on Left atrial (LA) reservoir strain (%) (β -2.097, 95% CI -3.507, -0.686, p=0.004). Isolated septal LGE location was independently associated with impaired LA reservoir strain (β = -2.097, P = 0.004) in patients with dilated cardiomyopathy.
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