Evaluation of Atrial Volume

The LA volumes are derived using the biplane area-length method, which is based on the formula Volume=0.85×Areafourchamber×AreatwochamberDperpendicularVolume=\frac{0.85\times Area_{four-chamber}\times Area_{two-chamber}}{D_{perpendicular}} (Nacif et al., 2012).

Biplane Area-Length Method

Nacif, M. S., Barranhas, A. D., Türkbey, E., Marchiori, E., Kawel, N., Mello, R. A. F., Falcão, R. O., Junior, A. C. O., & Rochitte, C. E. (2012). Left atrial volume quantification using cardiac MRI in atrial fibrillation: Comparison of the Simpson’s method with biplane area-length, ellipse, and three-dimensional methods. Diagnostic and Interventional Radiology. https://doi.org/10.5152/dir.2012.002


Sphericity index was calculated as the ratio of LA maximum volume to the volume of a sphere with maximum LA length diameter among atrial length and transverse length

Sphericity Index

Aquaro, G. D., Pizzino, F., Terrizzi, A., Carerj, S., Khandheria, B. K., & Di Bella, G. (2019). Diastolic dysfunction evaluated by cardiac magnetic resonance: The value of the combined assessment of atrial and ventricular function. European Radiology, 29(3), 1555–1564. https://doi.org/10.1007/s00330-018-5571-3


After deriving the atrial and ventricular dV/dt curves from the volume curves. Peaks of the ventricular dV/dt curves were defined as follows: the first positive peak was defined as the early peak filling rate (PFR-E) and the second peak was defined as atrial peak filling rate (PFR-A). PFR-E and PFR-A represent the maximum speed of passive filling and the maximum speed of filling secondary to atrial contraction, respectively. Between the two peaks, a zone of almost zero speed is normally present; this is the phase of diastasis.

PER and PFR

Nakamori, S., Ngo, L. H., Tugal, D., Manning, W. J., & Nezafat, R. (2018). Incremental Value of Left Atrial Geometric Remodeling in Predicting Late Atrial Fibrillation Recurrence After Pulmonary Vein Isolation: A Cardiovascular Magnetic Resonance Study. Journal of the American Heart Association, 7(19), e009793. https://doi.org/10.1161/JAHA.118.009793


Left atrial function has been typically divided into three integrated phases: reservoir, conduit and booster-pump (Figure 1) [7–10]. Reservoir: an expansion phase during left ventricular (LV) systole; the LA stores pulmonary venous return during LV contraction and isovolumic relaxation. Conduit: the LA transfers blood passively into the LV during ventricular diastole. Booster-pump: contractile component (when supraventricular rhythm is present);

Three phases1

Mehrzad, R., Rajab, M., & Spodick, D. (2014). The Three Integrated Phases of Left Atrial Macrophysiology and Their Interactions. International Journal of Molecular Sciences, 15(9), 15146–15160. https://doi.org/10.3390/ijms150915146

Three phases2

Peters, D. C., Lamy, J., Sinusas, A. J., & Baldassarre, L. A. (2021). Left atrial evaluation by cardiovascular magnetic resonance: Sensitive and unique biomarkers. European Heart Journal Cardiovascular Imaging, 23(1), 14–30. https://doi.org/10.1093/ehjci/jeab221

LAEF

Hoit, B. D. (2014). Left Atrial Size and Function. Journal of the American College of Cardiology, 63(6), 493–505. https://doi.org/10.1016/j.jacc.2013.10.055