Digital Poster 9: Atrial Strain quantification in a homogeneous cohort of healthy volunteers: Age Correlations and Sex-based Differences

Wednesday, January 29, 2025

5:30 PM – 6:00 PM East Coast USA Time

Location: Blue Room PreFunction

Presenting Author(s)

SG

Sebastiano Gambato, MD

Radiology resident
Azienda Ospedale Università di Padova, Italy

Primary Author(s)

AL

Amalia Lupi, MD, PhD

Post-doc radiologist
University of Padua, Italy

Co-Author(s)

GC

Giulio Cabrelle, MD

Radiology resident
University of Padua, Italy
SZ

Stefania Zinato, MRT

Dr
University of Padua, Italy
EQ

Emilio Quaia, MD

Prof
University of Padua, Italy
AP

Alessia Pepe, MD, PhD

Prof
University of Padua, Italy

Background: Cardiac Magnetic Resonance (CMR) is the gold standard for the myocardial function quantification, using Steady State Free Precession (SSFP) cine sequences. Currently, the analysis of myocardial deformation quantification is gaining traction as a tool for the early diagnosis of contractile disfunction. Likewise, left atrium (LA) mechanic dysfunction has been shown to be a predictor of adverse cardiovascular event and heart failure, and LA strain analysis could provide clinically valuable information for the management of patients with cardiovascular involvement. To achieve this goal, normal reference values are necessary to avoid misdiagnosis; to the best of our knowledge, there are currently few studies supplying normal LA strain ranges and differences among age and gender have never been explored. Thus, the aim of this study is to evaluate a homogeneous cohort of healthy subjects to identify the correlation between LA strain values, LA ejection fraction and the characteristics of the population and to provide normative strain values to serve as a baseline in the diagnostic process.

Methods: Fifty healthy subjects (M:F=1:1, 20-69 years) underwent CMR without contrast agent including long axis SSFP cine 2-, 3- and 4- chamber views. LA strain values were obtained by manually tracing endocardial and epicardial contours on the 2-, 3- and 4-chamber long axis views in cine SSFP sequences utilizing cvi42 software (Figure 1). LA ejection fraction (EF) was obtained through the automatic contour analysis tool on the 2- and 4-chamber view cine SSFP sequences. We quantified the time analysis for each patient. The association of the strain values, EF values, age and sex of the study population was assessed. A p-value < 0.05 was considered statistically significant.

Results:

Twenty-five males and females (five for each decade), mean age 43±13.8 years, were included. The mean time for the manual analysis was 45' (range 40-50). Long axis (LAX) peak longitudinal strain averaged at 23.9±3.0%, the LAX peak radial strain averaged at 57±12.6% (Figure 2) and the LA EF averaged at 64.48±6.2%. A weak negative correlation was found between peak LAX radial strain and age (rs=-0.31, p=0.02) (Figure 3). No correlations were found between LA EF and the age nor the sex of the volunteers. Likewise, no correlation was found between LAX longitudinal strain and the considered variables.

Conclusion: Cine SSFP sequences and feature tracking allow for LA strain analysis and a precise quantification of LA EF. The procedure is time consuming only for the analysis, being not available a dedicated automatic contouring tool for atrial strain. The correlation between LAX radial strain and age could represent a physiological decrease in atrial function with age. The obtained results could serve as normal values in diagnosing early myocardial disfunction with preserved EF and are provided for clinical and research purposes.