Dissecting Clinical and Metabolomics Associations of Left Atrial Phasic Function by Cardiac Magnetic Resonance Feature Tracking

Angela S Koh, Fei Gao, Shuang Leng, Jean-Paul Kovalik, Xiaodan Zhao, Ru San Tan, Kevin Timothy Fridianto, Jianhong Ching, Serene Jm Chua, Jian-Min Yuan, Woon-Puay Koh, Liang Zhong, Angela S Koh, Fei Gao, Shuang Leng, Jean-Paul Kovalik, Xiaodan Zhao, Ru San Tan, Kevin Timothy Fridianto, Jianhong Ching, Serene Jm Chua, Jian-Min Yuan, Woon-Puay Koh, Liang Zhong

Abstract

Among community cohorts, associations between clinical and metabolite factors and complex left atrial (LA) phasic function assessed by cardiac magnetic resonance (CMR) feature tracking (FT) are unknown. Longitudinal LA strain comprising reservoir strain (εs), conduit strain (εe) and booster strain (εa) and their corresponding peak strain rates (SRs, SRe, SRa) were measured using CMR FT. Targeted mass spectrometry measured 83 circulating metabolites in serum. Sparse Principal Component Analysis was used for data reduction. Among community adults (n = 128, 41% female) (mean age: 70.5 ± 11.6 years), age was significantly associated with εs (β = -0.30, p < 0.0001), εe (β = -0.3, p < 0.0001), SRs (β = -0.02, p < 0.0001), SRe (β = 0.04, p < 0.0001) and SRe/SRa (β = -0.01, p = 0.012). In contrast, heart rate was significantly associated with εa (β = 0.1, p = 0.001) and SRa (β = -0.02, p < 0.0001). Serine was significantly associated with εs (β = 10.1, p = 0.015), SRs (β = 0.5, p = 0.033) and SRa (β = -0.9, p = 0.016). Citrulline was associated with εs (β = -4.0, p = 0.016), εa (β = -3.4, p = 0.002) and SRa (β = 0.4, p = 0.019). Valine was associated with ratio of SRe:SRa (β = -0.4, p = 0.039). Medium and long chain dicarboxyl carnitines were associated with εs (β = -0.6, p = 0.038). Phases of LA function were differentially associated with clinical and metabolite factors. Metabolite signals may be used to advance mechanistic understanding of LA disease in future studies.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
(A,B) semi-automatic algorithm to track the distance (L) between the left atrioventricular junction and a user-defined point at the mid posterior left atrial (LA) wall on standard CMR 2- and 4-chamber views. (C,D) Longitudinal strain (ε) at any time point (t) in the cardiac cycle from end-diastole (time 0) was calculated as: ε(t) = (L(t) − L0)/L0. LA reservoir strain (εs), conduit strain (εe) and booster strain (εa) were calculated at t equals left ventricular end-systole, diastasis and pre-LA systole, respectively, and their corresponding peak strain rates (SR) derived.
Figure 2
Figure 2
Heat map of correlations betweewas associated with ratio of conduitn amino acids and outcomes individually. The correlations increased from purple to red. Significant correlations are coloured while non-significant correlations are colourless).

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