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Gueda Moussa M, Lamy J, Nguyen V, Marsac P, Gencer U, Mousseaux E, Bollache E, Kachenoura N. Estimate of the hydraulic force in the aging heart: a cardiovascular magnetic resonance imaging study. BMC Med Imaging 2024; 24:168. [PMID: 38977955 DOI: 10.1186/s12880-024-01303-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/20/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Coupling between left ventricle (LV) and left atrium (LA) plays a central role in the process of cardiac remodeling during aging and development of cardiac disease. The hydraulic force (HyF) is related to variation in size between LV and LA. The objectives of this study were to: (1) derive an estimate of left atrioventricular HyF using cine- Magnetic Resonance Imaging (MRI) in healthy subjects with a wide age range, and (2) study its relationship with age and conventional diastolic function parameters, as estimated by reference echocardiography. METHODS We studied 119 healthy volunteers (mean age 44 ± 17 years, 58 women) who underwent Doppler echocardiography and MRI on the same day. Conventional transmitral flow early (E) and late (A) LV filling peak velocities as well as mitral annulus diastolic longitudinal peak velocity (E') were derived from echocardiography. MRI cine SSFP images in longitudinal two and four chamber views were acquired, and analyzed using feature tracking (FT) software. In addition to conventional LV and LA strain measurements, FT-derived LV and LA contours were further used to calculate chamber cross-sectional areas. HyF was approximated as the difference between the LV and LA maximal cross-sectional areas in the diastasis phase corresponding to the lowest LV-LA pressure gradient. Univariate and multivariate analyses while adjusting for appropriate variables were used to study the associations between HyF and age as well as diastolic function and strain indices. RESULTS HyF decreased significantly with age (R²=0.34, p < 0.0001). In addition, HyF was significantly associated with conventional indices of diastolic function and LA strain: E/A: R²=0.24, p < 0.0001; E': R²=0.24, p < 0.0001; E/E': R²=0.12, p = 0.0004; LA conduit longitudinal strain: R²=0.27, p < 0.0001. In multivariate analysis, associations with E/A (R2 = 0.39, p = 0.03) and LA conduit strain (R2 = 0.37, p = 0.02) remained significant after adjustment for age, sex, and body mass index. CONCLUSIONS HyF, estimated using FT contours, which are primarily used to quantify LV/LA strain on standard cardiac cine MRI, varied significantly with age in association with subclinical changes in ventricular filling. Its usefulness in cohorts of patients with left heart disease to detect LV-LA uncoupling remains to be evaluated.
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Affiliation(s)
- Moussa Gueda Moussa
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS, INSERM, 15 Rue de École de Médecine, Paris, 75006, France
| | - Jérôme Lamy
- PARCC, Université Paris Cité, Inserm, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Vincent Nguyen
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS, INSERM, 15 Rue de École de Médecine, Paris, 75006, France
| | - Perrine Marsac
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS, INSERM, 15 Rue de École de Médecine, Paris, 75006, France
| | - Umit Gencer
- PARCC, Université Paris Cité, Inserm, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Elie Mousseaux
- PARCC, Université Paris Cité, Inserm, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emilie Bollache
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS, INSERM, 15 Rue de École de Médecine, Paris, 75006, France
| | - Nadjia Kachenoura
- Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, CNRS, INSERM, 15 Rue de École de Médecine, Paris, 75006, France.
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Yang Z, Tang Y, Sun W, Wen J, Tang D, Luo Y, Xiang C, Huang L, Xia L. Left Atrial Strain for Prediction of Left Ventricular Reverse Remodeling After ST-segment Elevation Myocardial Infarction by Cardiac Magnetic Resonance Feature Tracking. J Thorac Imaging 2024:00005382-990000000-00141. [PMID: 38856048 DOI: 10.1097/rti.0000000000000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
PURPOSE The study aimed to investigate the potential utility of left atrial (LA) strain by using cardiac magnetic resonance feature-tracking (CMR-FT) to predict left ventricular reverse remodeling (LVRR) following ST-segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS Patients with a first STEMI treated by primary percutaneous coronary intervention were consecutively enrolled in the prospective study and underwent CMR scans at 5 days and 4 months. LA global longitudinal strain (reservoir strain [εs], conduit strain [εe], booster strain [εa]) and corresponding strain rate were assessed by CMR-FT using cine images. LVRR was defined as a reduction in the LV end-systolic volume index of >10% from baseline to follow-up. Logistic regression analyses were performed to determine the predictors of LVRR. RESULTS Of 90 patients analyzed, patients with LVRR (n=35, 39%) showed higher values of LA strain and strain rate and less extensive infarct size (IS) compared with patients without LVRR (n=55, 61%) at initial and second CMR. The LVRR group demonstrated significant improvements in LV and LA cardiac function over time, especially the obvious increase in LA strain and strain rate. In multivariate logistic regression analyses, εs and εe, together with IS, were independent predictors of LVRR. The combination of εs and IS could optimally predict the LVRR with the highest area under the curve of 0.743. CONCLUSIONS Post-STEMI patients with LVRR presented better recovery from cardiac function and LA deformation compared with patients without LVRR. Assessment of εs and εe by using CMR-FT after STEMI enabled prediction of LVRR.
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Affiliation(s)
- Zhaoxia Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Yuanyuan Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Wenzhe Sun
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinyang Wen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Dazhong Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Yi Luo
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Chunlin Xiang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Lu Huang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Liming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
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Cai Q, Zhao Z, Gao J, Liu J, Li J, Peng X, Chen H. Normal Values for Atrial Deformation Measured by Feature-Tracking Cardiac MRI: A Meta-Analysis. J Magn Reson Imaging 2024. [PMID: 38807354 DOI: 10.1002/jmri.29465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/16/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND A consensus on normal atrial deformation measurements by feature-tracking cardiac MRI remained absent. PURPOSE Provide reference ranges for atrial strain parameters in normal subjects, evaluating the influence of field strength and analysis software on the measurements. STUDY TYPE Meta-analysis. POPULATION 2708 subjects from 42 studies undergoing cardiac MRI. ASSESSMENT A systematic search was conducted from database (PubMed, Web of Science, ScienceDirect, and EMBASE) inception through August 2023. The random-effects model was used to pool the means of biatrial strain parameters. Heterogeneity and clinical variable effects were assessed. Strain measurements among different field strengths and analysis software were compared. STATISTICAL TESTS The inverse-variance method, Cochrane Q statistic, and I2 value, meta-regression analysis, and ANOVA were used; P < 0.05 was considered statistically significant. RESULTS The pooled means of left atrial (LA) total strain (εs), passive strain (εe), and active strain (εa) were 37.46%, 22.73%, and 16.24%, respectively, and the pooled means of LA total strain rate (SRs), passive strain rate (SRe), and active strain rate (SRa) were 1.66, -1.95, and -1.83, indicating significant heterogeneity. The pooled means of right atrial (RA) εs, εe, and εa were 44.87%, 26.05%, and 18.83%. RA SRs, SRe, and SRa were 1.66, -1.95, and -1.83, respectively. The meta-regression identified age as significantly associated with LA εs, εe and SRe, field strength was associated with LA SRa (all P < 0.05). ANOVA revealed differences in LA εa and SRa among different analysis software and in LA εs and all LA strain rates (all P < 0.05) among field strengths. No significant differences were identified in RA strain across analysis software (RA strain: P = 0.145-0.749; RA strain rates: P = 0.073-0.744) and field strengths (RA strain: P = 0.641-0.794; RA strain rates: P = 0.204-0.458). DATA CONCLUSION This study demonstrated the pooled reference values of biatrial strain. Age, analysis software, and field strength were attributed to differences in LA strain, whereas RA strain showed consistency across different field strengths and analysis software. Limited study subjects may account for the absence of influence on RA strain. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY Stage 5.
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Affiliation(s)
- Qiuyi Cai
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Zhengkai Zhao
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Jin Gao
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Jian Liu
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Jianlin Li
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Xin Peng
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China
| | - Hang Chen
- Department of Radiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
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Yang Z, Wen J, Tang D, Luo Y, Xiang C, Xia L, Huang L. Sex-Related Differences of Left Atrial Strain in Patients With Hypertension Using Cardiac Magnetic Resonance Feature Tracking. J Thorac Imaging 2024; 39:W40-W47. [PMID: 37982515 DOI: 10.1097/rti.0000000000000760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
PURPOSE Previous studies demonstrated the impact of sex on left ventricular (LV) strain in patients with essential hypertension. However, little is known about the effect of sex on left atrial (LA) strain in patients with hypertension. This study aimed to explore the sex-related differences of LA strain by using cardiac magnetic resonance feature tracking in patients with hypertension and preserved LV ejection fraction. MATERIALS AND METHODS One hundred and fifty hypertensive patients (100 men and 50 women) and 105 age-matched and sex-matched normotensive controls (70 men and 35 women) were retrospectively enrolled and underwent cardiac magnetic resonance examination. LA strain parameters included LA reservoir strain (εs), conduit strain (εe), pump strain (εa), and their corresponding strain rate (SRs, SRe, and SRa). RESULTS Men had significantly higher LV mass index, lower εs and εe than women in both patients and controls (all P <0.05). LA strain and strain rate were significantly reduced in hypertensive patients compared with controls, both in men and women (all P <0.05). In men, hypertension and its interaction were associated with increased LV mass index and decreased εs and εe. In multivariable analysis, men, LV ejection fraction, and LA minimum volume index remained independent determinants of εs and εe in all hypertensive patients (all P <0.05). CONCLUSION LA strain was significantly impaired in hypertensive patients, and men had more impaired LA strain than women. These findings further emphasize the sex-related differences in the response of LA strain to hypertension in the early stage.
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Affiliation(s)
- Zhaoxia Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Yin L, Mei J, Dong J, Qu X, Jiang Y. Association of sodium intake with adverse left atrial function and left atrioventricular coupling in Chinese. J Hypertens 2023; 41:159-170. [PMID: 36453659 PMCID: PMC9794161 DOI: 10.1097/hjh.0000000000003317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/17/2022] [Accepted: 09/29/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES High sodium intake is strongly associated with hypertension and obesity. This study aims to investigate the relationship between 24-h urinary sodium (a surrogate measure of sodium intake), ambulatory blood pressure parameters, left atrial function, and left atrioventricular coupling. Further, we intend to examine whether blood pressure and BMI might be mediators of the relationship between 24-h urinary sodium and subclinical cardiac function. METHODS Our study had 398 participants, all of whom were subjected to 24-h urine collection, 24-h ambulatory blood pressure measurement, and cardiac magnetic resonance imaging. RESULTS The average age of the participants was 55.70 ± 11.30 years old. The mean urinary sodium of the participants was 172.01 ± 80.24 mmol/24 h. After adjusting for age, sex, history of diabetes, smoking status, alcohol consumption, and use of diuretics, 24-h urinary sodium was correlated with multiple ambulatory blood pressure parameters, BMI, left atrial function, and the left atrioventricular coupling index (LACI) (P < 0.05). Mediation analysis showed that BMI explained 16% of the indirect effect of 24-h urinary sodium and left atrial function and 30% of the indirect effect of LACI. Independent of the mediator, 24-h urinary sodium had a significant direct effect on left atrial function and left atrioventricular coupling. CONCLUSIONS Higher 24-h urinary sodium was associated with a greater BMI as well as poor left atrial function and left atrioventricular coupling, and the BMI mediated the relationship between 24-h urinary sodium and subclinical left cardiac function. Furthermore, and more importantly, 24-h urinary sodium may have directly affected the left atrial function and left atrioventricular coupling independent of intermediary factors.
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Affiliation(s)
- Lili Yin
- Second Affiliated Hospital of Dalian Medical University
| | - Jiajie Mei
- Second Affiliated Hospital of Dalian Medical University
| | - Jianli Dong
- Second Affiliated Hospital of Dalian Medical University
| | - Xiaofeng Qu
- Second Affiliated Hospital of Dalian Medical University
| | - Yinong Jiang
- First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Reference values of left and right atrial volumes and phasic function based on a large sample of healthy Chinese adults: A cardiovascular magnetic resonance study. Int J Cardiol 2022; 352:180-187. [DOI: 10.1016/j.ijcard.2022.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/05/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022]
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Choe YH. Editorial for "Reference Values for Left Atrial Strain and Strain Rate Based on a Large Sample of Healthy Chinese Adults: An MR-Feature Tracking Study". J Magn Reson Imaging 2021; 54:1794-1795. [PMID: 34236122 DOI: 10.1002/jmri.27821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yeon Hyeon Choe
- Department of Radiology and Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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