title: Left atrial active contractile function parameters assessed by cardiac MR are sensitive to myocardial iron.
abstract: To determine the impact of myocardial iron overload on left atrial (LA) volume and function using MR in patients with systemic iron overload.
  
  
  
  Thirty-eight patients with systemic iron overload disease and 10 controls underwent 1.5 Tesla MR performing steady state free precession short-axis cine-series of the LA. Three-dimensional-volumetry was assessed to calculate LA volumes and function. Parameters were indexed (i) to body surface area. The myocardial transverse relaxation rate R2* was determined in the ventricular septum using a multi-echo GRE sequence (breathhold; electrocardiography triggered; 12 echoes; echo time = 1.3-25.7 ms).
  
  
  
  Significantly decreased active atrial emptying fraction (AAEF) (23% [95%-range, 7-34] versus 36% [95%-range, 14-49], P = 0.009), active atrial emptying volume (AAEVi) (5.5 mL/m2[95%-range, 2-11] versus 11.9 mL/m2[95%-range, 3-23], P = 0.008), and active peak emptying rate (APERi) (46 mL/s/m2[95%-range, 29-69] versus 75 mL/s/m2[95%-range, 45-178], P < 0.001) were found for patients with myocardial iron overload (R2* > 40 s-1) compared with patients with normal myocardial iron levels (R2* < 40 s-1). Receiver operating characteristics (ROC) analysis revealed higher potential to indicate myocardial iron overload for the AAEF (area under the ROC curve [AUC] = 0.84; P < 0.0001), APERi (AUC = 0.87; P < 0.0001), and AAEVi (AUC = 0.80; P < 0.0001) compared with LA ejection fraction (LAEF) (AUC = 0.68; P = 0.02) with equal sensitivities and specificities of 82% (AAEF), 79% (APERi), 73% (AAEVi), and 57% (LAEF).
  
  
  
  MR parameters of active LA contractile function were associated with myocardial iron overload. This cross-sectional study suggests impaired active LA contractile function to be sensitive to myocardial iron toxicity.
  
  
  
  3 J. Magn. Reson. Imaging 2017;45:535-541.
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Mahmoud S
authors.initials: MS
authors.lastname: Wehbe
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Jin
authors.initials: J
authors.lastname: Yamamura
authors.affiliation: UCSF Benioff Children's Hospital and Research Center Oakland, Department of Hematology, Oakland, California, USA.|University Medical Center Hamburg-Eppendorf, Department of Pediatric Hematology/Oncology, Hamburg, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Fischer
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Pediatric Hematology/Oncology, Hamburg, Germany.
authors.forename: Regine
authors.initials: R
authors.lastname: Grosse
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Berliner
authors.affiliation: Siemens Healthcare GmbH, Hamburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Graessner
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Gunner
authors.initials: G
authors.lastname: Lund
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
authors.affiliation: University Medical Center Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg, Germany.
authors.forename: Bjoern P
authors.initials: BP
authors.lastname: Schoennagel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057791:Cardiac Imaging Techniques / Q000379:methods; D002648:Child; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007501:Iron / Q000378:metabolism*; D019190:Iron Overload / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D007501:Iron
keywords: cardiomyopathy; diastolic dysfunction; iron; magnetic resonance imaging