The assessment of atrial function by velocity-encoded magnetic resonance imaging

Abstract

Introduction: The purpose of this study was to assess velocity-encoded cardiac magnetic resonance imaging (Ve-CMR) in a population of patients referred for cardiac magnetic resonance imaging (CMR), to determine the variability of atrial function, and to identify clinical parameters associated with left atrial function. Methods: This is a prospective study evaluating patients who were referred to our CMR center for a clinical CMR. Left atrial function was obtained via Ve-CMR thru-plane images across the mitral valve after acquiring 2 perpendicular in-plane images as “scouts”. The atrial function and mitral inflow were quantified by computer analysis (Argus, Siemens). Atrial function was defined as atrial contraction (A-wave) volume divided by total inflow volume. Left atrial volumes were calculated via computer analysis. Mitral regurgitation and left ventricular ejection fractions were assessed visually. Results: Thirty-nine patients, with mean age 56 +/- 10 years, were enrolled. The mean left atrial function was 22.9% +/-14.5%; the range in left atrial function was 0% - 57%. There was a significant positive correlation between atrial function and increased left ventricular ejection fraction (r = 0.44, P < 0.01). There was a significant negative correlation between atrial function and severity of mitral regurgitation (r = -0.60, P < 0.01), as well as left atrial volume (r = -0.36, P = 0.02). Conclusion: Our results indicate a wide variability in left atrial function and a significant association between left atrial function and left ventricular ejection fraction, left atrial volume and mitral regurgitation.

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Vu, C. , Heitner, J. , Klem, I. , Cawley, P. , Crowley, A. , Patel, M. , Weinsaft, J. , Parker, M. , Elliott, M. , Judd, R. , Kim, R. and Greenfield Jr., J. (2013) The assessment of atrial function by velocity-encoded magnetic resonance imaging. World Journal of Cardiovascular Diseases, 3, 18-24. doi: 10.4236/wjcd.2013.32A003.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Braunwald, E. and Frahm, C.J. (1961) Studies on Starling’s law of the heart: IV. Observations on the hemodynamic functions of the left atrium in man. Circulation, 24, 633-642. doi:10.1161/01.CIR.24.3.633
[2] Thomas, J.D. and Weyman, A.E. (1991) Echocardiographic Doppler evaluation of left ventricular diastolic function. Circulation, 84, 977-990. doi:10.1161/01.CIR.84.3.977
[3] Gutman, J., Wang, Y.S., Wahr, D., et al. (1983) Normal left atrial function determined by 2-dimensional echocardiography. The American Journal of Cardiology, 51, 336340. doi:10.1016/S0002-9149(83)80061-7
[4] Rumberger, J.A., Weiss, R.M., Feiring, A.J., et al. (1989) Patterns of regional diastolic function in the normal human left ventricle: An ultrafast computed tomographic study. Journal of the American College of Cardiology, 14, 119-126. doi:10.1016/0735-1097(89)90061-2
[5] Bough, E.W., Gandsman, E.J. and Shulman, R.S. (1981) Measurement of normal left atrial function with gated radionuclide angiography. The American Journal of Cardiology, 48, 473-478. doi:10.1016/0002-9149(81)90075-8
[6] Jarvinen, V.M., Kupari, M.M., Poutanen, V.P., et al. (1996) A simplified method for the determination of left atrial size and function using cine magnetic resonance imaging. Magnetic Resonance Imaging, 14, 215-226. doi:10.1016/0730-725X(95)02098-E
[7] Mohiaddin, R.H., Amanuma, M., Kilner, P.J., et al. (1991) MR phase-shift velocity mapping of mitral and pulmonary venous flow. Journal of Computer Assisted Tomography, 15, 237-243. doi:10.1097/00004728-199103000-00009
[8] Hartiala, J.J., Mostbeck, G.H., Foster, E., et al. (1993) Velocity-encoded cine MRI in the evaluation of left ventricular diastolic function: Measurement of mitral valve and pulmonary vein flow velocities and flow volume across the mitral valve. American Heart Journal, 125, 1054-1066. doi:10.1016/0002-8703(93)90114-O
[9] Hartiala, J.J., Foster, E., Fujita, N., et al. (1994) Evaluation of left atrial contribution to left ventricular filling in aortic stenosis by velocity-encoded cine MRI. American Heart Journal, 127, 593-600. doi:10.1016/0002-8703(94)90668-8
[10] Mostbeck, G.H., Hartiala, J.J., Foster, E., et al. (1993) Right ventricular diastolic filling: Evaluation with velocity-encoded cine MRI. Journal of Computer Assisted Tomography, 17, 245-252. doi:10.1097/00004728-199303000-00013
[11] Heitner, J., Bhumireddy, G.P., Crowley, A.L., et al. (2012) Clinical application of cine-MRI in the visual assessment of mitral regurgitation compared to echocardiography and cardiac catheterization. PloS ONE, 7, e40491. doi:10.1371/journal.pone.0040491
[12] Sanfilippo, A.J., Abascal, V.M., Sheehan, M., et al. (1990) Atrial enlargement as a consequence of atrial fibrillation. A prospective echocardiographic study. Circulation, 82, 792-797. doi:10.1161/01.CIR.82.3.792
[13] Meisner, J.S., Keren, G., Pajaro, O.E., et al. (1991) Atrial contribution to ventricular filling in mitral stenosis. Circulation, 84, 1469-1480. doi:10.1161/01.CIR.84.4.1469
[14] Matsuda, Y., Toma, Y., Ogawa, H., et al. (1983) Importance of left atrial function in patients with myocardial infarction. Circulation, 67, 566-571. doi:10.1161/01.CIR.67.3.566
[15] Thomas, L., Foster, E. and Schiller, N.B. (1998) Peak mitral inflow velocity predicts mitral regurgitation severity. Journal of the American College of Cardiology, 31, 174-179. doi:10.1016/S0735-1097(97)00454-3
[16] Dubrey, S., Pollak, A., Skinner, M., et al. (1995) Atrial thrombi occurring during sinus rhythm in cardiac amyloidosis: Evidence for atrial electromechanical dissociation. British Heart Journal, 74, 541-544. doi:10.1136/hrt.74.5.541
[17] Little, W.C. and Freeman, G.L. (2006) Pericardial disease. Circulation, 113, 1622-1632. doi:10.1161/CIRCULATIONAHA.105.561514
[18] Manning, W.J., Silverman, D.I., Katz, S.E., et al. (1994) Impaired left atrial mechanical function after cardioversion: Relation to the duration of atrial fibrillation. Journal of the American College of Cardiology, 23, 1535-1540. doi:10.1016/0735-1097(94)90652-1
[19] Westenberg, J.J., Roes, S.D., Ajmone Marsan, N., et al. (2008) Mitral valve and tricuspid valve blood flow: Accurate quantification with 3D velocity-encoded MR imaging with retrospective valve tracking. Radiology, 249, 792-800. doi:10.1148/radiol.2492080146
[20] Matsuda, Y., Toma, Y., Moritani, K., et al. (1986) Assessment of left atrial function in patients with hypertensive heart disease. Hypertension, 8, 779-785. doi:10.1161/01.HYP.8.9.779
[21] Oki, T., Iuchi, A., Tabata, T., et al. (1998) Left atrial contribution to left ventricular filling in patients with mitral stenosis: Combined analysis of transmitral and pulmonary venous flow velocities. Echocardiography, 15, 43-50. doi:10.1111/j.1540-8175.1998.tb00576.x
[22] Prioli, A., Marino, P., Lanzoni, L., et al. (1998) Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. The American Journal of Cardiology, 82, 756-761. doi:10.1016/S0002-9149(98)00452-4
[23] Phan, T.T., Abozguia, K., Shivu, G.N., et al. (2009) Increased atrial contribution to left ventricular filling compensates for impaired early filling during exercise in heart failure with preserved ejection fraction. Journal of Cardiac Failure, 15, 890-897. doi:10.1016/j.cardfail.2009.06.440

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