Association of MRI Left Atrial Strain With Ischemic Stroke in Myocardial Infarction Patients
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· 2025
· Open Access
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· DOI: https://doi.org/10.1002/jmri.29833
· OA: W4410933260
Background Patients with myocardial infarction (MI) have a high risk of ischemic stroke (IS). Left atrial (LA) strain is associated with IS, but the relationship between them remains unclear in patients with MI. Purpose To evaluate the relationship between MRI‐derived LA strain and IS in patients with MI. Study Type Retrospective. Population Seven hundred eighty patients were diagnosed with acute MI (AMI), including 549 with ST‐segment elevation MI (STEMI) and 231 with non‐STEMI (NSTEMI). Field Strength/Sequence 3.0 T, balanced turbo field echo cine sequence. Assessment Cardiac MRI was performed during hospitalization for AMI. LA reservoir and conduit strains were determined automatically from cine data by feature tracking (FT) software, and their association with IS was determined after correcting for possible confounders, such as new‐onset atrial fibrillation (AF) and CHA 2 DS 2 ‐VASc score. Statistical Tests Cox regression models to explore the association between LA strain and IS; receiver operating characteristic (ROC) curve analysis to assess the ability of LA strain to identify IS and to determine high/low LA strain cutoff values; Kaplan–Meier curves for long‐term IS risk assessment. A p value < 0.05 was considered significant. Results The MR study was performed with a median of 5 (interquartile range: 4–6) days after admission. During a median follow‐up of 29.1 months (interquartile range: 19.4–39.6), 38 (4.9%) patients had a new IS. After adjusting for AF and CHA 2 DS 2 ‐VASc, Cox regression analysis showed that both LA reservoir strain (hazard ratio [HR]: 0.933; 95% confidence interval (CI): 0.894–0.973) and LA conduit strain (HR: 0.909; 95% CI: 0.846–0.978) were independently associated with IS. Kaplan–Meier curves showed that patients with low LA strain had a significantly higher long‐term risk of IS than patients with high LA strain. Data Conclusion LA strain is significantly associated with the incidence of IS after MI, even after adjusting for AF and CHA 2 DS 2 ‐VASc. Evidence Level Level 4. Technical Efficacy Stage 5.
