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Aims The use of apical views focused on the left atrium (LA) has improved the accuracy of LA volume evaluation by two-dimensional echocardiography. However, routine cardiac magnetic resonance (CMR) evaluation of LA volumes still uses standard 2- and 4-chamber cine images focused on the left ventricle. To investigate the potential of LA-focused CMR cine images, we compared LA maximal (LAVmax) and minimal (LAVmin) volumes, and emptying fraction (LA-EF) calculated on both standard and LA-focused long-axis cine images with LA volumes obtained by short-axis cine stacks covering the LA. Methods and results LA volumes and LA-EF were obtained from 108 consecutive patients by applying the biplane area-length algorithm to both standard and LA-focused 2- and 4-chamber cine images. Manual segmentation of a short-axis cine stack covering the LA was used as the reference method. Compared to the reference method, the standard approach significantly underestimated LA volumes (LAVmax: bias −13 ml; LOA = +11 ml, −37 ml; LAVmin; bias −10 ml, LOA: +9 ml, −28ml), and overestimated LA-EF (bias= 5%, LOA: +23%, −14%). Conversely, LA volumes (LAVmax bias −0.03 ml; LOA: +10 ml, −10 ml. LAVmin bias = −1.5 ml; LOA: +7 ml, −10 ml), and LA-EF (bias 2%, LOA: +11%, −7%) by LA-focused cine images were similar to those measured using the reference method. Moreover, LA volumes by LA-focused images were obtained faster than using the reference method (1.2 vs. 4.5 min, P &amp;lt; 0.001). Conclusions LA volumes and LA-EF measured using dedicated LA-focused long-axis cine imaging are more accurate than using standard (LV-focused) cine images.

european heart journal supplements

366 The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and function measured by cardiovascular magnetic resonance