Associations between 3D-based Left Atrial Volumetric and Blood Flow Parameters in a Single-Site Cohort of the Multi-Ethnic Study of Atherosclerosis.
Maurice Pradella, Justin J Baraboo, Anthony Maroun, Sophia Z Liu, Amanda L DiCarlo, Stanley H Chu, Julia M Hwang, Mitchell A Collins, Rod Passman, Susan R Heckbert, Philip Greenland, Michael Markl
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Abstract
Purpose To investigate associations between left atrial volume (LAV) and function with impaired three-dimensional hemodynamics from four-dimensional flow MRI. Materials and Methods A subcohort of participants from the Multi-Ethnic Study of Atherosclerosis from Northwestern University underwent prospective 1.5-T cardiac MRI including whole-heart four-dimensional flow and short-axis cine imaging between 2019 and 2020. Four-dimensional flow MRI analysis included manual three-dimensional segmentations of the LA and LA appendage (LAA), which were used to quantify LA and LAA peak velocity and blood stasis (% voxels < 0.1 m/sec). Short-axis cine data were used to delineate LA contours on all cardiac time points, and the resulting three-dimensional-based LAVs were extracted for calculation of LA emptying fractions (LAEFtotal , LAEFactive , LAEFpassive ). Stepwise multivariable linear models were calculated for each flow parameter (LA stasis, LA peak velocity, LAA stasis, LAA peak velocity) to determine associations with LAV and LAEF. Results This study included 158 participants (mean age, 73 years ± 7 [SD]; 83 [52.5%] female and 75 [47.4%] male participants). In multivariable models, a 1-unit increase of LAEFtotal was associated with decreased LA stasis (β coefficient, -0.47%; P < .001), while increased LAEFactive was associated with increased LA peak velocity (β coefficient, 0.21 cm/sec; P < .001). Furthermore, increased minimum LAV indexed was most associated with impaired LAA flow (higher LAA stasis [β coefficient, 0.65%; P < .001] and lower LAA peak velocity [β coefficient, -0.35 cm/sec; P < .001]). Conclusion Higher minimum LAV and reduced LA function were associated with impaired flow characteristics in the LA and LAA. LAV assessment might therefore be a surrogate measure for LA and LAA flow abnormalities. Keywords: Atherosclerosis, Left Atrial Volume, Left Atrial Blood Flow, 4D Flow MRI Supplemental material is available for this article . © RSNA, 2024.
多种族动脉粥样硬化研究单点队列中基于三维的左心房容积参数和血流参数之间的关联。
目的 研究左心房容积(LAV)和功能与四维血流 MRI 中受损的三维血流动力学之间的关联。材料与方法 美国西北大学多种族动脉粥样硬化研究(Multi-Ethnic Study of Atherosclerosis)亚群参与者在 2019 年至 2020 年期间接受了前瞻性 1.5 T 心脏 MRI 检查,包括全心四维血流和短轴电影成像。四维血流 MRI 分析包括 LA 和 LA 附肢 (LAA) 的手动三维分割,用于量化 LA 和 LAA 峰值速度和血液淤滞(< 0.1 米/秒的体素百分比)。短轴电影数据用于勾勒所有心脏时间点的 LA 轮廓,并提取由此产生的基于三维的 LAV,用于计算 LA 排空分数(LAEFtotal、LAEFactive、LAEFpassive)。针对每个血流参数(LA淤积、LA峰值速度、LAA淤积、LAA峰值速度)计算逐步多变量线性模型,以确定与LAV和LAEF的关系。结果 本研究共纳入 158 名参与者(平均年龄为 73 岁 ± 7 [SD];女性 83 [52.5%],男性 75 [47.4%])。在多变量模型中,LAEFtotal 增加 1 个单位与 LA 淤血减少有关(β 系数,-0.47%;P < .001),而 LAEFactive 增加与 LA 峰值速度增加有关(β 系数,0.21 厘米/秒;P < .001)。此外,最小 LAV 指数增加与 LAA 血流受损关系最大(更高的 LAA 淤积率 [β系数,0.65%;P < .001] 和更低的 LAA 峰值速度 [β系数,-0.35 厘米/秒;P < .001])。结论 LAV最小值升高和LA功能减退与LA和LAA血流特征受损有关。因此,LAV评估可能是衡量LA和LAA血流异常的替代指标。关键词动脉粥样硬化 左心房容积 左心房血流 四维血流 MRI 本文有补充材料。© RSNA, 2024.
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