Ventricular-atrial coupling in subjects with normal, preserved, and reduced left ventricular ejection fraction: insights from cardiac magnetic resonance imaging
Objectives To assess the correlation between LA and LV strain measurements in different clinical scenarios and evaluate to what extent LA deformation contributes to the prognosis of patients. Methods A total of 297 consecutive participants including 75 healthy individuals, 75 hypertrophic cardiomyop...
Gespeichert in:
| Veröffentlicht in: | European radiology 2023-11, Vol.33 (11), p.7716-7728 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 7728 |
|---|---|
| container_issue | 11 |
| container_start_page | 7716 |
| container_title | European radiology |
| container_volume | 33 |
| creator | Zhou, Di Wang, Yining Li, Shuang Wu, Weichun Sun, Xiaoxin Zhuang, Baiyan He, Jian Xu, Jing Yang, Wenjing Zhu, Leyi Sirajuddin, Arlene Teng, Zhongzhao Zhao, Shihua Lu, Minjie |
| description | Objectives
To assess the correlation between LA and LV strain measurements in different clinical scenarios and evaluate to what extent LA deformation contributes to the prognosis of patients.
Methods
A total of 297 consecutive participants including 75 healthy individuals, 75 hypertrophic cardiomyopathy (HCM) patients, 74 idiopathic dilated cardiomyopathy (DCM), and 73 chronic myocardial infarction (MI) patients were retrospectively enrolled in this study. The associations of LA-LV coupling with clinical status were statistically analyzed by correlation, multiple linear regression, and logistic regression. Survival estimates were calculated by receiver operating characteristic analyses and Cox regression analyses.
Results
Overall, moderate correlations were found between LA and LV strain in every phase of the cardiac cycle (
r
: −0.598 to −0.580, all
p
< 0.001). The slope of the regression line of the individual strain-strain curve had a significant difference among 4 groups (−1.4 ± 0.3 in controls, −1.1 ± 0.6 in HCM, −1.8 ± 0.8 in idiopathic DCM, −2.4 ± 1.1 in chronic MI, all
p
< 0.05). During a median follow-up of 4.7 years, the total LA emptying fraction was independently associated with primary (hazard ratio: 0.968, 95% CI: 0.951–0.985) and secondary endpoints (hazard ratio: 0.957, 95% CI: 0.930–0.985) with an area under the curve (AUC) of 0.720 respectively, 0.806, which was significantly higher than the AUC of LV parameters.
Conclusions
The coupled correlations between the left atria and ventricle in every phase and the individual strain-strain curve vary with etiology. LA deformation in late diastole provides prior and incremental information on cardiac dysfunction based on LV metrics. The total LA emptying fraction was an independent indicator for clinical outcome superior to that of LV typical predictors.
Clinical relevance statement
Left ventricular-atrial coupling is not only valuable for comprehending the pathophysiological mechanisms of cardiovascular diseases caused by different etiologies but also holds significant importance for the prevention of adverse cardiovascular events and targeted treatment.
Key Points
• In HCM patients with preserved LVEF, LA deformation is a sensitive indicator for cardiac dysfunction prior to LV parameters with a reduced LA/LV strain ratio.
• In patients with reduced LVEF, LV deformation impairment is more consequential than that of the LA with an increased LA/LV strain ratio. Furthermore, impaired LA active stra |
| doi_str_mv | 10.1007/s00330-023-09801-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2826219400</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2881053186</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-59453138b36a57a69e2d26417fb5b0eb85802a1d35ed4c0e87e12d95f545ee5b3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi1ERcvCC3BAlrhwaMrYjhOHW1UBRarUC3C1HHuy9SqxFzsp2rfhUevtFop64ORf9j_fjOcn5A2DMwbQfsgAQkAFXFTQKWDV7hk5YbXgFQNVP_9HH5OXOW8AoGN1-4Ici1Yw1YA4Ib9_YJiTt8toUmWKMiO1cdmOPqypDzQv_QbtnOkvP9_QENNkxlO6TZgx3aI7pSY4mtAtFh0dcZjp7SOQ4r7Wx0CHZO7Fx8LMfn1TgEOKE7UmOW8sncw64OxtQeUYTLBIfbkrQ7wiR4MZM75-OFfk--dP3y4uq6vrL18vzq8qK1o5V7KrpWBC9aIxsjVNh9zxpmbt0MsesFdSATfMCYmutoCqRcZdJwdZS0TZixV5f-BuU_y5YJ715LPFcTQB45I1V7zhrKvLzlfk3RPrJi4plOmKSzGQ--UWFz-4bIo5Jxz0NpU_pZ1moPf56UN-uuSn7_PTu1L09gG99BO6vyV_AisGcTDk8hTWmB57_wd7BxLdqUc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2881053186</pqid></control><display><type>article</type><title>Ventricular-atrial coupling in subjects with normal, preserved, and reduced left ventricular ejection fraction: insights from cardiac magnetic resonance imaging</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zhou, Di ; Wang, Yining ; Li, Shuang ; Wu, Weichun ; Sun, Xiaoxin ; Zhuang, Baiyan ; He, Jian ; Xu, Jing ; Yang, Wenjing ; Zhu, Leyi ; Sirajuddin, Arlene ; Teng, Zhongzhao ; Zhao, Shihua ; Lu, Minjie</creator><creatorcontrib>Zhou, Di ; Wang, Yining ; Li, Shuang ; Wu, Weichun ; Sun, Xiaoxin ; Zhuang, Baiyan ; He, Jian ; Xu, Jing ; Yang, Wenjing ; Zhu, Leyi ; Sirajuddin, Arlene ; Teng, Zhongzhao ; Zhao, Shihua ; Lu, Minjie</creatorcontrib><description>Objectives
To assess the correlation between LA and LV strain measurements in different clinical scenarios and evaluate to what extent LA deformation contributes to the prognosis of patients.
Methods
A total of 297 consecutive participants including 75 healthy individuals, 75 hypertrophic cardiomyopathy (HCM) patients, 74 idiopathic dilated cardiomyopathy (DCM), and 73 chronic myocardial infarction (MI) patients were retrospectively enrolled in this study. The associations of LA-LV coupling with clinical status were statistically analyzed by correlation, multiple linear regression, and logistic regression. Survival estimates were calculated by receiver operating characteristic analyses and Cox regression analyses.
Results
Overall, moderate correlations were found between LA and LV strain in every phase of the cardiac cycle (
r
: −0.598 to −0.580, all
p
< 0.001). The slope of the regression line of the individual strain-strain curve had a significant difference among 4 groups (−1.4 ± 0.3 in controls, −1.1 ± 0.6 in HCM, −1.8 ± 0.8 in idiopathic DCM, −2.4 ± 1.1 in chronic MI, all
p
< 0.05). During a median follow-up of 4.7 years, the total LA emptying fraction was independently associated with primary (hazard ratio: 0.968, 95% CI: 0.951–0.985) and secondary endpoints (hazard ratio: 0.957, 95% CI: 0.930–0.985) with an area under the curve (AUC) of 0.720 respectively, 0.806, which was significantly higher than the AUC of LV parameters.
Conclusions
The coupled correlations between the left atria and ventricle in every phase and the individual strain-strain curve vary with etiology. LA deformation in late diastole provides prior and incremental information on cardiac dysfunction based on LV metrics. The total LA emptying fraction was an independent indicator for clinical outcome superior to that of LV typical predictors.
Clinical relevance statement
Left ventricular-atrial coupling is not only valuable for comprehending the pathophysiological mechanisms of cardiovascular diseases caused by different etiologies but also holds significant importance for the prevention of adverse cardiovascular events and targeted treatment.
Key Points
• In HCM patients with preserved LVEF, LA deformation is a sensitive indicator for cardiac dysfunction prior to LV parameters with a reduced LA/LV strain ratio.
• In patients with reduced LVEF, LV deformation impairment is more consequential than that of the LA with an increased LA/LV strain ratio. Furthermore, impaired LA active strain indicates potential atrial myopathy.
• Among LA and LV parameters, the total LA emptying fraction is the best predictor for guiding clinical management and follow-up in patients with different statuses of LVEF.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-023-09801-y</identifier><identifier>PMID: 37318603</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Atria ; Atrial Fibrillation ; Cardiomyopathy ; Cardiomyopathy, Dilated - complications ; Cardiomyopathy, Hypertrophic ; Cardiovascular diseases ; Correlation ; Coupling ; Diagnostic Radiology ; Diastole ; Dilated cardiomyopathy ; Emptying ; Etiology ; Health hazards ; Heart Atria - diagnostic imaging ; Heart Ventricles - diagnostic imaging ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Magnetic Resonance ; Magnetic Resonance Imaging ; Medical prognosis ; Medicine ; Medicine & Public Health ; Myocardial infarction ; Myopathy ; Neuroradiology ; Parameter sensitivity ; Patients ; Radiology ; Regression analysis ; Retrospective Studies ; Strain ; Stroke Volume ; Ultrasound ; Ventricle ; Ventricular Function, Left</subject><ispartof>European radiology, 2023-11, Vol.33 (11), p.7716-7728</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to European Society of Radiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-59453138b36a57a69e2d26417fb5b0eb85802a1d35ed4c0e87e12d95f545ee5b3</citedby><cites>FETCH-LOGICAL-c375t-59453138b36a57a69e2d26417fb5b0eb85802a1d35ed4c0e87e12d95f545ee5b3</cites><orcidid>0000-0001-8696-318X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-023-09801-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-023-09801-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37318603$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Di</creatorcontrib><creatorcontrib>Wang, Yining</creatorcontrib><creatorcontrib>Li, Shuang</creatorcontrib><creatorcontrib>Wu, Weichun</creatorcontrib><creatorcontrib>Sun, Xiaoxin</creatorcontrib><creatorcontrib>Zhuang, Baiyan</creatorcontrib><creatorcontrib>He, Jian</creatorcontrib><creatorcontrib>Xu, Jing</creatorcontrib><creatorcontrib>Yang, Wenjing</creatorcontrib><creatorcontrib>Zhu, Leyi</creatorcontrib><creatorcontrib>Sirajuddin, Arlene</creatorcontrib><creatorcontrib>Teng, Zhongzhao</creatorcontrib><creatorcontrib>Zhao, Shihua</creatorcontrib><creatorcontrib>Lu, Minjie</creatorcontrib><title>Ventricular-atrial coupling in subjects with normal, preserved, and reduced left ventricular ejection fraction: insights from cardiac magnetic resonance imaging</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To assess the correlation between LA and LV strain measurements in different clinical scenarios and evaluate to what extent LA deformation contributes to the prognosis of patients.
Methods
A total of 297 consecutive participants including 75 healthy individuals, 75 hypertrophic cardiomyopathy (HCM) patients, 74 idiopathic dilated cardiomyopathy (DCM), and 73 chronic myocardial infarction (MI) patients were retrospectively enrolled in this study. The associations of LA-LV coupling with clinical status were statistically analyzed by correlation, multiple linear regression, and logistic regression. Survival estimates were calculated by receiver operating characteristic analyses and Cox regression analyses.
Results
Overall, moderate correlations were found between LA and LV strain in every phase of the cardiac cycle (
r
: −0.598 to −0.580, all
p
< 0.001). The slope of the regression line of the individual strain-strain curve had a significant difference among 4 groups (−1.4 ± 0.3 in controls, −1.1 ± 0.6 in HCM, −1.8 ± 0.8 in idiopathic DCM, −2.4 ± 1.1 in chronic MI, all
p
< 0.05). During a median follow-up of 4.7 years, the total LA emptying fraction was independently associated with primary (hazard ratio: 0.968, 95% CI: 0.951–0.985) and secondary endpoints (hazard ratio: 0.957, 95% CI: 0.930–0.985) with an area under the curve (AUC) of 0.720 respectively, 0.806, which was significantly higher than the AUC of LV parameters.
Conclusions
The coupled correlations between the left atria and ventricle in every phase and the individual strain-strain curve vary with etiology. LA deformation in late diastole provides prior and incremental information on cardiac dysfunction based on LV metrics. The total LA emptying fraction was an independent indicator for clinical outcome superior to that of LV typical predictors.
Clinical relevance statement
Left ventricular-atrial coupling is not only valuable for comprehending the pathophysiological mechanisms of cardiovascular diseases caused by different etiologies but also holds significant importance for the prevention of adverse cardiovascular events and targeted treatment.
Key Points
• In HCM patients with preserved LVEF, LA deformation is a sensitive indicator for cardiac dysfunction prior to LV parameters with a reduced LA/LV strain ratio.
• In patients with reduced LVEF, LV deformation impairment is more consequential than that of the LA with an increased LA/LV strain ratio. Furthermore, impaired LA active strain indicates potential atrial myopathy.
• Among LA and LV parameters, the total LA emptying fraction is the best predictor for guiding clinical management and follow-up in patients with different statuses of LVEF.</description><subject>Atria</subject><subject>Atrial Fibrillation</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Dilated - complications</subject><subject>Cardiomyopathy, Hypertrophic</subject><subject>Cardiovascular diseases</subject><subject>Correlation</subject><subject>Coupling</subject><subject>Diagnostic Radiology</subject><subject>Diastole</subject><subject>Dilated cardiomyopathy</subject><subject>Emptying</subject><subject>Etiology</subject><subject>Health hazards</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Magnetic Resonance</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Myocardial infarction</subject><subject>Myopathy</subject><subject>Neuroradiology</subject><subject>Parameter sensitivity</subject><subject>Patients</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Strain</subject><subject>Stroke Volume</subject><subject>Ultrasound</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kcFu1DAQhi1ERcvCC3BAlrhwaMrYjhOHW1UBRarUC3C1HHuy9SqxFzsp2rfhUevtFop64ORf9j_fjOcn5A2DMwbQfsgAQkAFXFTQKWDV7hk5YbXgFQNVP_9HH5OXOW8AoGN1-4Ici1Yw1YA4Ib9_YJiTt8toUmWKMiO1cdmOPqypDzQv_QbtnOkvP9_QENNkxlO6TZgx3aI7pSY4mtAtFh0dcZjp7SOQ4r7Wx0CHZO7Fx8LMfn1TgEOKE7UmOW8sncw64OxtQeUYTLBIfbkrQ7wiR4MZM75-OFfk--dP3y4uq6vrL18vzq8qK1o5V7KrpWBC9aIxsjVNh9zxpmbt0MsesFdSATfMCYmutoCqRcZdJwdZS0TZixV5f-BuU_y5YJ715LPFcTQB45I1V7zhrKvLzlfk3RPrJi4plOmKSzGQ--UWFz-4bIo5Jxz0NpU_pZ1moPf56UN-uuSn7_PTu1L09gG99BO6vyV_AisGcTDk8hTWmB57_wd7BxLdqUc</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Zhou, Di</creator><creator>Wang, Yining</creator><creator>Li, Shuang</creator><creator>Wu, Weichun</creator><creator>Sun, Xiaoxin</creator><creator>Zhuang, Baiyan</creator><creator>He, Jian</creator><creator>Xu, Jing</creator><creator>Yang, Wenjing</creator><creator>Zhu, Leyi</creator><creator>Sirajuddin, Arlene</creator><creator>Teng, Zhongzhao</creator><creator>Zhao, Shihua</creator><creator>Lu, Minjie</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8696-318X</orcidid></search><sort><creationdate>20231101</creationdate><title>Ventricular-atrial coupling in subjects with normal, preserved, and reduced left ventricular ejection fraction: insights from cardiac magnetic resonance imaging</title><author>Zhou, Di ; Wang, Yining ; Li, Shuang ; Wu, Weichun ; Sun, Xiaoxin ; Zhuang, Baiyan ; He, Jian ; Xu, Jing ; Yang, Wenjing ; Zhu, Leyi ; Sirajuddin, Arlene ; Teng, Zhongzhao ; Zhao, Shihua ; Lu, Minjie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-59453138b36a57a69e2d26417fb5b0eb85802a1d35ed4c0e87e12d95f545ee5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Atria</topic><topic>Atrial Fibrillation</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Dilated - complications</topic><topic>Cardiomyopathy, Hypertrophic</topic><topic>Cardiovascular diseases</topic><topic>Correlation</topic><topic>Coupling</topic><topic>Diagnostic Radiology</topic><topic>Diastole</topic><topic>Dilated cardiomyopathy</topic><topic>Emptying</topic><topic>Etiology</topic><topic>Health hazards</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Magnetic Resonance</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Myocardial infarction</topic><topic>Myopathy</topic><topic>Neuroradiology</topic><topic>Parameter sensitivity</topic><topic>Patients</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Strain</topic><topic>Stroke Volume</topic><topic>Ultrasound</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Di</creatorcontrib><creatorcontrib>Wang, Yining</creatorcontrib><creatorcontrib>Li, Shuang</creatorcontrib><creatorcontrib>Wu, Weichun</creatorcontrib><creatorcontrib>Sun, Xiaoxin</creatorcontrib><creatorcontrib>Zhuang, Baiyan</creatorcontrib><creatorcontrib>He, Jian</creatorcontrib><creatorcontrib>Xu, Jing</creatorcontrib><creatorcontrib>Yang, Wenjing</creatorcontrib><creatorcontrib>Zhu, Leyi</creatorcontrib><creatorcontrib>Sirajuddin, Arlene</creatorcontrib><creatorcontrib>Teng, Zhongzhao</creatorcontrib><creatorcontrib>Zhao, Shihua</creatorcontrib><creatorcontrib>Lu, Minjie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Di</au><au>Wang, Yining</au><au>Li, Shuang</au><au>Wu, Weichun</au><au>Sun, Xiaoxin</au><au>Zhuang, Baiyan</au><au>He, Jian</au><au>Xu, Jing</au><au>Yang, Wenjing</au><au>Zhu, Leyi</au><au>Sirajuddin, Arlene</au><au>Teng, Zhongzhao</au><au>Zhao, Shihua</au><au>Lu, Minjie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventricular-atrial coupling in subjects with normal, preserved, and reduced left ventricular ejection fraction: insights from cardiac magnetic resonance imaging</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>33</volume><issue>11</issue><spage>7716</spage><epage>7728</epage><pages>7716-7728</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To assess the correlation between LA and LV strain measurements in different clinical scenarios and evaluate to what extent LA deformation contributes to the prognosis of patients.
Methods
A total of 297 consecutive participants including 75 healthy individuals, 75 hypertrophic cardiomyopathy (HCM) patients, 74 idiopathic dilated cardiomyopathy (DCM), and 73 chronic myocardial infarction (MI) patients were retrospectively enrolled in this study. The associations of LA-LV coupling with clinical status were statistically analyzed by correlation, multiple linear regression, and logistic regression. Survival estimates were calculated by receiver operating characteristic analyses and Cox regression analyses.
Results
Overall, moderate correlations were found between LA and LV strain in every phase of the cardiac cycle (
r
: −0.598 to −0.580, all
p
< 0.001). The slope of the regression line of the individual strain-strain curve had a significant difference among 4 groups (−1.4 ± 0.3 in controls, −1.1 ± 0.6 in HCM, −1.8 ± 0.8 in idiopathic DCM, −2.4 ± 1.1 in chronic MI, all
p
< 0.05). During a median follow-up of 4.7 years, the total LA emptying fraction was independently associated with primary (hazard ratio: 0.968, 95% CI: 0.951–0.985) and secondary endpoints (hazard ratio: 0.957, 95% CI: 0.930–0.985) with an area under the curve (AUC) of 0.720 respectively, 0.806, which was significantly higher than the AUC of LV parameters.
Conclusions
The coupled correlations between the left atria and ventricle in every phase and the individual strain-strain curve vary with etiology. LA deformation in late diastole provides prior and incremental information on cardiac dysfunction based on LV metrics. The total LA emptying fraction was an independent indicator for clinical outcome superior to that of LV typical predictors.
Clinical relevance statement
Left ventricular-atrial coupling is not only valuable for comprehending the pathophysiological mechanisms of cardiovascular diseases caused by different etiologies but also holds significant importance for the prevention of adverse cardiovascular events and targeted treatment.
Key Points
• In HCM patients with preserved LVEF, LA deformation is a sensitive indicator for cardiac dysfunction prior to LV parameters with a reduced LA/LV strain ratio.
• In patients with reduced LVEF, LV deformation impairment is more consequential than that of the LA with an increased LA/LV strain ratio. Furthermore, impaired LA active strain indicates potential atrial myopathy.
• Among LA and LV parameters, the total LA emptying fraction is the best predictor for guiding clinical management and follow-up in patients with different statuses of LVEF.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37318603</pmid><doi>10.1007/s00330-023-09801-y</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-8696-318X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2023-11, Vol.33 (11), p.7716-7728 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2826219400 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Atria Atrial Fibrillation Cardiomyopathy Cardiomyopathy, Dilated - complications Cardiomyopathy, Hypertrophic Cardiovascular diseases Correlation Coupling Diagnostic Radiology Diastole Dilated cardiomyopathy Emptying Etiology Health hazards Heart Atria - diagnostic imaging Heart Ventricles - diagnostic imaging Humans Imaging Internal Medicine Interventional Radiology Magnetic Resonance Magnetic Resonance Imaging Medical prognosis Medicine Medicine & Public Health Myocardial infarction Myopathy Neuroradiology Parameter sensitivity Patients Radiology Regression analysis Retrospective Studies Strain Stroke Volume Ultrasound Ventricle Ventricular Function, Left |
| title | Ventricular-atrial coupling in subjects with normal, preserved, and reduced left ventricular ejection fraction: insights from cardiac magnetic resonance imaging |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T05%3A35%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ventricular-atrial%20coupling%20in%20subjects%20with%20normal,%20preserved,%20and%20reduced%20left%20ventricular%20ejection%20fraction:%20insights%20from%20cardiac%20magnetic%20resonance%20imaging&rft.jtitle=European%20radiology&rft.au=Zhou,%20Di&rft.date=2023-11-01&rft.volume=33&rft.issue=11&rft.spage=7716&rft.epage=7728&rft.pages=7716-7728&rft.issn=1432-1084&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-023-09801-y&rft_dat=%3Cproquest_cross%3E2881053186%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2881053186&rft_id=info:pmid/37318603&rfr_iscdi=true |