Left atrial reservoir and conduit strain were independent predictors of adverse outcomes in idiopathic dilated cardiomyopathy, with HRs of 0.95 and 0.92 per 1% increase, respectively.
Does left atrial strain derived from cardiac MRI predict adverse clinical outcomes in patients with idiopathic dilated cardiomyopathy?
Left atrial reservoir and conduit strain assessed by cardiac MRI are independent predictors of mortality and heart transplant in patients with idiopathic dilated cardiomyopathy.
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Background There is increasing recognition that left atrial (LA) function is prognostically important in cardiovascular disease. LA strain is a sensitive parameter to describe complex LA phasic function. However, the prognostic value of LA strain in participants with idiopathic dilated cardiomyopathy (DCM) remains unclear. Purpose To evaluate the prognostic value of LA strain derived from cardiac MRI in study participants with idiopathic DCM. Materials and Methods Participants with idiopathic DCM who underwent cardiac MRI between June 2012 and November 2018 were prospectively enrolled. The fast long-axis strain MRI method was performed to assess LA strain. The primary end point was all-cause mortality and heart transplant, and the secondary end point was a combination of primary end point, heart failure readmission, and aborted sudden cardiac death. Cox regression analyses and Kaplan-Meier survival analysis were performed to identify the association between variables and outcomes. Results There were 497 participants (mean age, 47 years ± 14 standard deviation; 357 men) evaluated. During a median follow-up of 36 months (interquartile range, 26-54 months), 113 participants reached primary end points and 203 participants reached secondary end points. LA reservoir, conduit and booster strain, and strain rate were lower in participants with primary end points (P P = .008] and 0.92 95% CI: 0.87, 0.98; P = .010, respectively) and secondary end points (HR per 1% increase, 0.95 [95% CI: 0.93, 0.97; P P P Online supplemental material is available for this article. See also the editorial by Ambale-Venkatesh in this issue.
Li et al. (Tue,) reported a other. Left atrial reservoir and conduit strain were independent predictors of adverse outcomes in idiopathic dilated cardiomyopathy, with HRs of 0.95 and 0.92 per 1% increase, respectively.