title: Association of left atrial function and left atrial enhancement in patients with atrial fibrillation: cardiac magnetic resonance study.
abstract: BACKGROUND
  Atrial fibrillation (AF) is associated with left atrial (LA) structural and functional changes. Cardiac magnetic resonance late gadolinium enhancement (LGE) and feature-tracking are capable of noninvasive quantification of LA fibrosis and myocardial motion, respectively. We sought to examine the association of phasic LA function with LA enhancement in patients with AF.
  
  
  RESULTS
  LA structure and function was measured in 90 patients with AF (age 61±10 years; 76% men) referred for ablation and 14 healthy volunteers. Peak global longitudinal LA strain, LA systolic strain rate, and early and late diastolic strain rates were measured using cine-cardiac magnetic resonance images acquired during sinus rhythm. The degree of LGE was quantified. Compared with patients with paroxysmal AF (60% of cohort), those with persistent AF had larger maximum LA volume index (56±17 versus 49±13 mL/m(2); P=0.036), and increased LGE (27.1±11.7% versus 36.8±14.8%; P<0.001). Aside from LA active emptying fraction, all LA parameters (passive emptying fraction, peak global longitudinal LA strain, systolic strain rate, early diastolic strain rate, and late diastolic strain rate) were lower in patients with persistent AF (P<0.05 for all). Healthy volunteers had less LGE and higher LA functional parameters compared with patients with AF (P<0.05 for all). In multivariable analysis, increased LGE was associated with lower LA passive emptying fraction, peak global longitudinal LA strain, systolic strain rate, early diastolic strain rate, and late diastolic strain rate (P<0.05 for all).
  
  
  CONCLUSIONS
  Increased LA enhancement is associated with decreased LA reservoir, conduit, and booster pump functions. Phasic measurement of LA function using feature-tracking cardiac magnetic resonance may add important information about the physiological importance of LA fibrosis.
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. mhabibi3@jhmi.edu.
authors: Mohammadali
authors: M
authors: Habibi
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Joao A C
authors: JA
authors: Lima
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Irfan M
authors: IM
authors: Khurram
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Stefan L
authors: SL
authors: Zimmerman
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Vadim
authors: V
authors: Zipunnikov
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Kotaro
authors: K
authors: Fukumoto
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: David
authors: D
authors: Spragg
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Hiroshi
authors: H
authors: Ashikaga
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: John
authors: J
authors: Rickard
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Joseph E
authors: JE
authors: Marine
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Hugh
authors: H
authors: Calkins
authors: From the Department of Cardiology (M.H., J.A.C.L., I.M.K., K.F., D.S., H.A., J.R., J.E.M., H.C., S.N.), Department of Radiology (S.L.Z.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Biostatistics (V.Z.), Department of Epidemiology (S.N.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Saman
authors: S
authors: Nazarian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D005355:Fibrosis; D019786:Gadolinium DTPA; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: atrial fibrillation; atrial function, left; gadolinium; magnetic resonance imaging
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