Baseline left atrial booster strain (5.8 vs 11.4; P<0.00001) and total LA ejection fraction (32.9 vs 44.0; P<0.00001) by CMR were significantly lower in HCM patients who developed atrial fibrillation.
Case-Control (n=210)
No
Do left atrial phasic function and strain mechanics assessed by CMR predict the development of atrial fibrillation in patients with hypertrophic cardiomyopathy?
Impaired left atrial booster strain and total left atrial ejection fraction on baseline CMR are independent predictors of incident atrial fibrillation in patients with hypertrophic cardiomyopathy.
Absolute Event Rate: 5.8% vs 11.4%
p-value: p=<0.00001
Background: To evaluate whether the left atrium (LA) phasic function and myocardial deformation by cardiovascular magnetic resonance (CMR) in Hypertrophic cardiomyopathy (HCM) patients is a predictor of atrial fibrillation (AF) development. Methods:The baseline CMRs of HCM patients who later developed AF (n=140; mean age=61 12 years; male=86) were compared with those of HCM patients who did not develop AF (n=70; mean age=58 11 years; male=48).This case control study was conducted at our quaternary referral center between January 2001 and June 2021.The univariate and multivariable Cox proportional hazards model was used to assess the correlation between clinical and imaging parameters versus the likelihood of developing AF.Results: Compared to the non-AF cohort, HCM patients with AF had larger baseline LA volumes and lower LA strain and LA strain rates.Maximum LV wall thickness, absolute and indexed LV mass, and indexed LV end-diastolic volume were larger in patients with AF versus the non-AF group.LV ejection fraction (EF) assessed by CMR along with the LGE (late gadolinium enhancement) prevalence and pattern were similar between patients with and without AF.LA booster strain (5.83.4 in AF group vs 11.44.2 in non-AF group, P<0.00001) and total LA EF (32.912.8 in AF group vs 44.09.3 in non-AF group, P <0.00001) were significantly worse at baseline in AF group.There was no significant relationship between markers of LV disease burden and AF.Conclusions: LA booster strain and total LA EF at baseline CMR correlated with the AF development in HCM patients.
Montazeri et al. (2026) conducted a case-control in Hypertrophic cardiomyopathy (n=210). Cardiovascular magnetic resonance (CMR) parameters vs. Patients who did not develop AF was evaluated on LA booster strain (p=<0.00001). Baseline left atrial booster strain (5.8 vs 11.4; P<0.00001) and total LA ejection fraction (32.9 vs 44.0; P<0.00001) by CMR were significantly lower in HCM patients who developed atrial fibrillation.