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Association between left ventricular longitudinal function and left atrial strain in left ventricular dysfunction

Östenson, Björn LU orcid ; Bergström, Elsa LU orcid ; Steding-Ehrenborg, Katarina LU ; Venkateshvaran, Ashwin LU orcid ; Carlsson, Marcus LU ; Arheden, Håkan LU and Ostenfeld, Ellen LU orcid (2026) In ESC Heart Failure 13(2).
Abstract

INTRODUCTION: Left ventricular (LV) longitudinal function is a prognostic marker of hospitalization and mortality in LV dysfunction. Recently, left atrial (LA) reservoir and conduit strain have also been presented as independent prognostic markers. However, the atria and ventricles are coupled in the fibrous atrioventricular plane (LA-LV coupling). The degree to which the LA strain is affected, or even determined, by the LV longitudinal function in LV dysfunction has been explored by echocardiography, but not by cardiac magnetic resonance imaging (CMR). Therefore, we aimed to quantify the association between LV longitudinal ventricular function and LA strain using CMR feature-tracking. METHODS: Three hundred and forty-two patients with... (More)

INTRODUCTION: Left ventricular (LV) longitudinal function is a prognostic marker of hospitalization and mortality in LV dysfunction. Recently, left atrial (LA) reservoir and conduit strain have also been presented as independent prognostic markers. However, the atria and ventricles are coupled in the fibrous atrioventricular plane (LA-LV coupling). The degree to which the LA strain is affected, or even determined, by the LV longitudinal function in LV dysfunction has been explored by echocardiography, but not by cardiac magnetic resonance imaging (CMR). Therefore, we aimed to quantify the association between LV longitudinal ventricular function and LA strain using CMR feature-tracking. METHODS: Three hundred and forty-two patients with LV dysfunction (including heart failure with reduced ejection fraction (HFrEF), candidates for cardiac resynchronization therapy (CRT) implantation, and ischaemic heart disease (IHD)), and 19 healthy controls (HC) who had undergone CMR were retrospectively included. LV global longitudinal strain (LV-GLS), LV atrioventricular plane displacement (AVPD), and LA-GLS (i.e. reservoir strain) were analysed in long-axis views using CMR feature-tracking. RESULTS: LA-GLS was lower in the LV dysfunction group when compared to HC (12 ± 8% vs 19 ± 7, P < .001), mirroring reductions in LV-GLS (-10 ± 5% vs -19 ± 3, P < .001), and LV-AVPD (9 ± 3 vs 15 ± 2 mm, P < .001). The coefficient of determination (r2) between LV-GLS and LA-GLS was .40 (95% CI 0.32-0.48) for the whole cohort, and 0.39 (95% CI 0.31-0.47) between LV-AVPD and LA-GLS. CONCLUSION: In a large cohort comprising both patients with LV dysfunction and HC, LA reservoir function quantified as LA-GLS was to a large extent determined by LV longitudinal function. LA function may not be an independent marker of global cardiac function for certain patient groups where diminished LA function can be a reflection of LV dysfunction.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial function, Atrioventricular coupling, CMR, Global longitudinal strain, Ventricular function
in
ESC Heart Failure
volume
13
issue
2
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:41711211
  • scopus:105033517987
ISSN
2055-5822
DOI
10.1093/eschf/xvag046
language
English
LU publication?
yes
id
1518b09d-3ada-42d0-b0a0-9fd02fa5a6da
date added to LUP
2026-04-17 15:04:23
date last changed
2026-05-15 18:38:24
@article{1518b09d-3ada-42d0-b0a0-9fd02fa5a6da,
  abstract     = {{<p>INTRODUCTION: Left ventricular (LV) longitudinal function is a prognostic marker of hospitalization and mortality in LV dysfunction. Recently, left atrial (LA) reservoir and conduit strain have also been presented as independent prognostic markers. However, the atria and ventricles are coupled in the fibrous atrioventricular plane (LA-LV coupling). The degree to which the LA strain is affected, or even determined, by the LV longitudinal function in LV dysfunction has been explored by echocardiography, but not by cardiac magnetic resonance imaging (CMR). Therefore, we aimed to quantify the association between LV longitudinal ventricular function and LA strain using CMR feature-tracking. METHODS: Three hundred and forty-two patients with LV dysfunction (including heart failure with reduced ejection fraction (HFrEF), candidates for cardiac resynchronization therapy (CRT) implantation, and ischaemic heart disease (IHD)), and 19 healthy controls (HC) who had undergone CMR were retrospectively included. LV global longitudinal strain (LV-GLS), LV atrioventricular plane displacement (AVPD), and LA-GLS (i.e. reservoir strain) were analysed in long-axis views using CMR feature-tracking. RESULTS: LA-GLS was lower in the LV dysfunction group when compared to HC (12 ± 8% vs 19 ± 7, P &lt; .001), mirroring reductions in LV-GLS (-10 ± 5% vs -19 ± 3, P &lt; .001), and LV-AVPD (9 ± 3 vs 15 ± 2 mm, P &lt; .001). The coefficient of determination (r2) between LV-GLS and LA-GLS was .40 (95% CI 0.32-0.48) for the whole cohort, and 0.39 (95% CI 0.31-0.47) between LV-AVPD and LA-GLS. CONCLUSION: In a large cohort comprising both patients with LV dysfunction and HC, LA reservoir function quantified as LA-GLS was to a large extent determined by LV longitudinal function. LA function may not be an independent marker of global cardiac function for certain patient groups where diminished LA function can be a reflection of LV dysfunction.</p>}},
  author       = {{Östenson, Björn and Bergström, Elsa and Steding-Ehrenborg, Katarina and Venkateshvaran, Ashwin and Carlsson, Marcus and Arheden, Håkan and Ostenfeld, Ellen}},
  issn         = {{2055-5822}},
  keywords     = {{Atrial function; Atrioventricular coupling; CMR; Global longitudinal strain; Ventricular function}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{ESC Heart Failure}},
  title        = {{Association between left ventricular longitudinal function and left atrial strain in left ventricular dysfunction}},
  url          = {{http://dx.doi.org/10.1093/eschf/xvag046}},
  doi          = {{10.1093/eschf/xvag046}},
  volume       = {{13}},
  year         = {{2026}},
}