title: Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis.
abstract: Diastolic dysfunction is a major cause of morbidity in obese individuals. We aimed to assess the ability of magnetic resonance imaging (MRI) derived left atrial (LA) strain to detect early diastolic dysfunction in individuals with obesity and type 2 diabetes, and to explore the association between cardiac adipose tissue and LA function.
  
  
  
  Twenty patients with obesity and T2D (55 ± 8 years) and nineteen healthy controls (48 ± 13 years) were imaged using cine steady state free precession and 2-point Dixon cardiovascular magnetic resonance. LA function was quantified using a feature tracking technique with definition of phasic longitudinal strain and strain rates, as well as radial motion fraction and radial velocities.
  
  
  
  Systolic left ventricular size and function were similar between the obesity and type 2 diabetes and control groups by MRI. All patients except four had normal diastolic assessment by echocardiography. In contrast, measures of LA function using magnetic resonance feature tracking were uniformly altered in the obesity and type 2 diabetes group only. Although there was no significant difference in intra-myocardial fat fraction, Dixon 3D epicardial fat volume(EFV) was significantly elevated in the obesity and type 2 diabetes versus control group (135 ± 31 vs. 90 ± 30 mL/m2, p < 0.001). There were significant correlations between LA functional indices and both BMI and EFV (p ≤ 0.007).
  
  
  
  LA MRI-strain may be a sensitive tool for the detection of early diastolic dysfunction in individuals with obesity and type 2 diabetes and correlated with BMI and epicardial fat supporting a possible association between adiposity and LA strain. Trials Registration Australian New Zealand Clinical Trials Registry No. ACTRN12613001069741.
authors.affiliation: Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia.|Sydney Medical School, University of Sydney, Camperdown, Australia.|Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS 1146, CNRSUMR 7371, Laboratoire d'Imagerie Biomédicale, ICAN Institute of Cardiometabolism and Nutrition, Paris, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Evin
authors.affiliation: Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia.|Sydney Medical School, University of Sydney, Camperdown, Australia.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Broadhouse
authors.affiliation: Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia.|Sydney Medical School, University of Sydney, Camperdown, Australia.
authors.forename: Fraser M
authors.initials: FM
authors.lastname: Callaghan
authors.affiliation: Department of Endocrinology, Royal North Shore Hospital, St Leonards, Australia.|Kolling Institute, University of Sydney, Sydney, Australia.
authors.forename: Rachel T
authors.initials: RT
authors.lastname: McGrath
authors.affiliation: Department of Endocrinology, Royal North Shore Hospital, St Leonards, Australia.|Kolling Institute, University of Sydney, Sydney, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Glastras
authors.affiliation: Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia.|Sydney Medical School, University of Sydney, Camperdown, Australia.|Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kozor
authors.affiliation: Department of Endocrinology, Royal North Shore Hospital, St Leonards, Australia.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Hocking
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS 1146, CNRSUMR 7371, Laboratoire d'Imagerie Biomédicale, ICAN Institute of Cardiometabolism and Nutrition, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Lamy
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS 1146, CNRSUMR 7371, Laboratoire d'Imagerie Biomédicale, ICAN Institute of Cardiometabolism and Nutrition, Paris, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Redheuil
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS 1146, CNRSUMR 7371, Laboratoire d'Imagerie Biomédicale, ICAN Institute of Cardiometabolism and Nutrition, Paris, France.
authors.forename: Nadjia
authors.initials: N
authors.lastname: Kachenoura
authors.affiliation: Department of Endocrinology, Royal North Shore Hospital, St Leonards, Australia.|Kolling Institute, University of Sydney, Sydney, Australia.
authors.forename: Greg R
authors.initials: GR
authors.lastname: Fulcher
authors.affiliation: Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia.|Sydney Medical School, University of Sydney, Camperdown, Australia.|Department of Cardiology, Royal North Shore Hospital, St Leonards, Australia.
authors.forename: Gemma A
authors.initials: GA
authors.lastname: Figtree
authors.affiliation: Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia. stuart.grieve@sydney.edu.au.|Sydney Medical School, University of Sydney, Camperdown, Australia. stuart.grieve@sydney.edu.au.|Departments of Radiology, Royal North Shore Hospital and Royal Prince Alfred Hospital, Sydney, Australia. stuart.grieve@sydney.edu.au.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Grieve
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000503:physiopathology; D050154:Adiposity; D000328:Adult; D000465:Algorithms; D016279:Atrial Function, Left; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003971:Diastole; D042241:Early Diagnosis; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012307:Risk Factors; D016277:Ventricular Function, Left
keywords: Cardiac dysfunction; Diastolic dysfunction; Fat distribution; Magnetic resonance studies; Obesity and type 2