Abstract 12841: Association Between Left Atrial Regional Function Assessed by Novel Tissue Tracking MRI and the Risk of Stroke in Patients With Atrial Fibrillation
Introduction: Recent evidence suggests that left atrial (LA) fibrosis detected by late gadolinium enhancement magnetic resonance imaging (MRI) is significantly associated with the risk of stroke in patients with atrial fibrillation (AF). The presence and extent of fibrosis could potentially be estimated by quantifying LA regional dysfunction. This study aimed to determine the association between LA regional dysfunction using novel, user-friendly, multimodality tissue tracking (MTT) to quantify myocardial wall motion in cine MRI and prior history of stroke in patients with AF.
Methods: Consecutive patients with history of AF referred for ablation underwent pre-ablation MRI. The stroke group was identified as those with a prior history of stroke or transient ischemic attack (TIA), and the remaining patients were designated as the control group. In all patients LA regional function was assessed by MTT during sinus rhythm. The patients in AF at the time of MRI were excluded. Univariate and multivariate comparisons were made by using logistic regression model.
Results: A total of 202 patients (59 ± 10 years, 76% male, 29% persistent AF) were included in the study. Univariate analysis showed larger LA volume index (P=0.001), lower global, active, and passive emptying fraction (P=0.02, 0.04, and 0.03), lower strain (Smax and SpreA) (P=0.003 and P=0.01) and lower strain rate (SRs and SRe) (P=0.006 and P=0.04) in the stroke group (n=19, 62.9 ± 10.3 years) compared to the control group (n=183, 58.8 ± 10.1 years). Multivariate analysis showed significantly lower Smax and SRs in the stroke group (OR 0.88 and 0.05, p=0.03 and 0.04 respectively) after adjusting for age, sex, body mass index, LV ejection fraction, type of AF, and CHADS score.
Conclusions: LA structure and regional function are independently associated with stroke/TIA. LA regional dysfunction detected by MTT in cine MRI images could represent a marker for stroke and a possible therapeutic target in patients with AF.
Author Disclosures: Y. Inoue: None. A. Alissa: None. M. Habibi: None. K. Fukumoto: None. I. Khurram: None. S. Nazarian: None. H. Calkins: None. J.A. Lima: Research Grant; Significant; Toshiba Medical Systems. H. Ashikaga: None.
- © 2014 by American Heart Association, Inc.