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| Diagnostic Efficacy of CMR-Based Left Atrial Strain Parameters for Left Ventricular Fibrosis in Patients with Dilated Cardiomyopathy |
| YUAN Shuai, LI Yun |
| Department of Magnetic Resonance Imaging, Zhengzhou Seventh People's Hospital, Zhengzhou Henan 450000 |
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Abstract 【Objective】 To explore the diagnostic efficacy of cardiac magnetic resonance (CMR)-based left atrial strain parameters for left ventricular fibrosis in patients with dilated cardiomyopathy (DCM). 【Methods】 A total of 42 patients diagnosed with DCM complicated with left ventricular fibrosis in our hospital from January 2022 to January 2025 were prospectively enrolled as the observation group. Meanwhile, 42 healthy volunteers who underwent CMR examination during the same period were selected as the control group. Left ventricular and left atrial functional parameters were compared between the two groups, including left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), stroke volume (SV), left ventricular ejection fraction (LVEF), cardiac output (CO), cardiac index (CI), left ventricular end-diastolic myocardial mass (LVEDM), as well as left atrial strain parameters: left atrial reservoir strain (LARS), left atrial conduit strain (LACS), left atrial booster strain (LABS), late negative peak strain rate (SRa), early negative peak strain rate (SRe), and systolic peak strain rate (SRs). Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of left atrial strain parameters for left ventricular fibrosis. 【Results】 The observation group had higher LVEDV, LVESV, heart rate (HR) and LVEDM, and lower SV, LVEF, CO and CI than the control group, with statistically significant differences (P<0.05). All left atrial strain parameters including LARS, LACS, LABS, SRa, SRe and SRs in the observation group were significantly lower than those in the control group (P<0.05). Multivariate Logistic regression analysis showed that LARS, LACS, LABS and SRs were independent correlated factors for the occurrence of DCM fibrosis (P<0.05). ROC curve analysis indicated that LARS yielded the highest single-test sensitivity (100.0%), while LABS presented identical and favorable specificity (92.86%). The area under the curve (AUC) and Youden index of combined detection were significantly higher than those of single parameter detection (P<0.05). 【Conclusion】 CMR-based left atrial strain parameters are closely correlated with left ventricular fibrosis in DCM patients. The combined detection achieves the optimal diagnostic efficacy, and single LARS detection presents the best sensitivity, which can serve as potential non-invasive indicators for clinical evaluation of left ventricular fibrosis in DCM patients.
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Received: 26 October 2025
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