Abstract 18920: Left Atrial Function is Associated With Left Ventricular Mass in Women With Preserved Left Ventricular Ejection Fraction and Late Gadolinium Enhancement on Cardiac MRI

Abstract

Introduction: Myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI may be related to conditions with increased left ventricular (LV) mass and diastolic dysfunction. Women have an increased incidence of LV diastolic dysfunction and poorer clinical outcomes compared to men. Aim: To examine gender-based associations between LV mass and left atrial total emptying fraction (LATEF), a surrogate for diastolic function, in patients with LGE on cardiac MRI. Methods: We analyzed 134 consecutive patients undergoing cardiac MRI and LGE sequences on a 1.5T GE scanner. LV mass and LV/LA volumes (indexed by BSA) were measured offline from cine SSFP images using Precession software. Presence of LGE was reported. Nonparametric analyses were performed. Results: 40 patients with more than mild mitral regurgitation, pericardial disease, or LVEF <50% were excluded. 94 patients studied (49% women) had a median age of 51 years [IQR 38-67] with no gender-based difference. Median LV mass index (LVMi) for all patients was 69.5 g/m2 [IQR 57-82] and was higher in LGE vs no-LGE patients (p<0.001) and higher in men vs women (p<0.05). Median LATEF for all patients was 0.50 [IQR 0.41-0.54] and was lower in LGE vs no-LGE patients (p<0.001) with no gender-based difference. LVMi had a strong inverse correlation with LATEF for all patients and for the LGE group (r=-0.58, p<0.001 and r=-0.51, p<0.001 respectively). LVMi had a very strong inverse correlation with LATEF (r=-0.74, p<<0.001) in women with LGE and moderate inverse correlation in women with no-LGE (r=-0.45, p=0.02). LVMi had a moderate inverse correlation with LATEF in men with LGE (r=-0.48, p. <0.01) and no correlation in men with no-LGE (Figure). Conclusions: LA function inversely correlates with indexed LV mass, most strongly in women with LV LGE. Further exploration of these parameters may allow earlier detection of LV diastolic dysfunction and improved risk stratification.