Age- and Sex-Specific MR-Feature Tracking Reference Values of Right Atrial Deformation in Healthy Adults

Abstract

Background: Although right atrial (RA) myocardial deformation has important implications for patient diagnosis, prognosis, and risk stratification, its implementation in clinical practice has been hampered by limited normal reference values, especially in Asian populations. Purpose: To establish age- and sex-specific reference values for RA strain, strain rate (SR), and displacement based on a large sample of healthy Chinese adults using MR-feature tracking (MR-FT). Study Type: Retrospective. Population: 524 healthy Chinese adults (287 male; mean age 43.7 ± 11.9 years). Field Strength/Sequence: 1.5T/balanced steady-state free precession. Assessment: RA deformation parameters, including reservoir, conduit, and booster strain (εs, εe, and εa), peak positive, early negative, and late negative SR (SRs, SRe, and SRa), and total, passive, and active displacement (Ds, De, and Da), were assessed using MR-FT. Statistical Tests: Student's t-test, one-way ANOVA, coefficients of determination (r2), intraclass correlation coefficients (ICC), and Bland–Altman plots. A P value <0.05 was considered significant. Results: Women demonstrated significantly greater magnitudes of RA deformation parameters than men: εs (57.4% ± 15.1% vs. 44.3% ± 12.6%), εe (37.5% ± 13.4% vs. 27.4% ± 10.9%), εa (19.9% ± 5.7% vs. 16.9% ± 5.0%), SRs (2.62 ± 0.88 sec−1 vs. 2.00 ± 0.63 sec−1), SRe (−2.98 ± 1.26 sec−1 vs. −2.16 ± 0.92 sec−1), SRa (−2.28 ± 0.75 sec−1 vs. −1.84 ± 0.62 sec−1), Ds (−7.80 ± 1.90 mm vs. −7.46 ± 1.70 mm), and De (−4.84 ± 1.31 mm vs. −4.49 ± 1.21 mm). For both sexes, aging was significantly associated with decreased RA reservoir and conduit function (εs, SRs, Ds, εe, SRe, and De), and with increased εa and Da. RA deformation measurements had good to excellent intraobserver and interobserver reproducibility, with ICCs ranging from to 0.790 to 0.972. Data Conclusion: This study provides age- and sex-specific reference values of RA strain, SR, and displacement based on a large cohort of healthy Chinese adults using MR-FT. Level of Evidence: 3. Technical Efficacy: Stage 2.