Abstract
Purpose: To investigate associations between left atrial volume (LAV) and function with impaired three-dimensional hemodynamics from four-dimensional flow MRI. Materials and Methods: A subcohort of participants from the Multi-Ethnic Study of Atherosclerosis from Northwestern University underwent prospective 1.5-T cardiac MRI including whole-heart four-dimensional flow and short-axis cine imaging between 2019 and 2020. Four-dimensional flow MRI analysis included manual three-dimensional segmentations of the LA and LA appendage (LAA), which were used to quantify LA and LAA peak velocity and blood stasis (% voxels < 0.1 m/sec). Short-axis cine data were used to delineate LA contours on all cardiac time points, and the resulting three-dimensional–based LAVs were extracted for calculation of LA emptying fractions (LAEFtotal, LAEFactive, LAEFpassive). Stepwise multivariable linear models were calculated for each flow parameter (LA stasis, LA peak velocity, LAA stasis, LAA peak velocity) to determine associations with LAV and LAEF. Results: This study included 158 participants (mean age, 73 years ± 7 [SD]; 83 [52.5%] female and 75 [47.4%] male participants). In multivariable models, a 1-unit increase of LAEFtotal was associated with decreased LA stasis (β coefficient, −0.47%; P <.001), while increased LAEFactive was associated with increased LA peak velocity (β coefficient, 0.21 cm/sec; P <.001). Furthermore, increased minimum LAV indexed was most associated with impaired LAA flow (higher LAA stasis [β coefficient, 0.65%; P <.001] and lower LAA peak velocity [β coefficient, −0.35 cm/sec; P <.001]). Conclusion: Higher minimum LAV and reduced LA function were associated with impaired flow characteristics in the LA and LAA. LAV assessment might therefore be a surrogate measure for LA and LAA flow abnormalities.
Original language | English (US) |
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Article number | e230148 |
Journal | Radiology: Cardiothoracic Imaging |
Volume | 6 |
Issue number | 2 |
DOIs | |
State | Published - Apr 2024 |
Funding
Supported by contracts from the National Heart, Lung, and Blood Institute (contract nos. 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169), grants from the National Center for Advancing Translational Sciences (NCATS) (grant nos. UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420), and by the American Heart Association Strategically Focused Research Network on atrial fibrillation (project no. 18SFRN34110170). Disclosures of conflicts of interest: M.P. Support from Bangerter-Rhyner Foundation and Freiwillige Akademische Gesellschaft Basel. J.J.B. F31 training grant from the National Institutes of Health (grant no. 5F31HL165915). A.M. No relevant relationships. S.Z.L. No relevant relationships. A.L.D. No relevant relationships. S.H.C. No relevant relationships. J.M.H. No relevant relationships. M.A.C. No relevant relationships. R.P. Funding from the American Heart Association paid to institution. S.R.H. Payment from the National Institutes of Health and American Heart Association made to institution; participation on National Heart, Lung, and Blood Institute observational study monitoring board for the Hispanic Community Health Study/Study of Latinos. P.G. Support from the American Heart Association; participation on the University of Pennsylvania and Wake Forest University data safety monitoring boards and the National Heart, Lung, and Blood Institute Framingham Heart Study observational study monitoring board. M.M. Member of the Radiology: Cardiothoracic Imaging editorial board.
Keywords
- 4D Flow MRI
- Atherosclerosis
- Left Atrial Blood Flow
- Left Atrial Volume
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging