Atrial fibrillation and atrial remodeling
Atrial fibrillation is closely linked to atrial enlargement, impaired reservoir and booster function, altered atrial geometry, and ventricular filling abnormalities. CardiacNexus exposes atrial structure and function features that make this remodeling visible.
- Modality
- Cine long-axis CMR
- Pipeline step
- Clinical interpretation
- Outputs
- Atrial volume, emptying, sphericity, and phase-function phenotypes
- Maturity
- Clinician review draft
What clinicians look for
Readers usually inspect LA maximum and minimum volume, indexed LA volume where available, emptying fractions, expansion index, PER-E/PER-A, RA volume, and LA sphericity. Atrial size alone may miss functional impairment, especially before overt geometric remodeling [1].
Relevant CardiacNexus phenotypes
| Phenotype page | Measurements to inspect | Interpretation role |
|---|---|---|
| Atrial structure | LA/RA volumes, diameters, LA sphericity | Atrial remodeling burden |
| Atrial function | Reservoir, conduit, booster EF, PER | Phasic atrial mechanics |
| Ventricular function | EF, SV, CO | Ventricular interaction |
| Cross-chamber phenotypes | AVPD and atrial contribution | Long-axis coupling and filling context |
| Valvular and flow phenotypes | Mitral/tricuspid context where available | Valve-associated atrial remodeling |
Interpretation patterns
Higher LA volume and more spherical LA geometry are reported in atrial remodeling cohorts. Reduced LA emptying function can reflect impaired reservoir, conduit, or booster function, but rhythm at acquisition and ECG timing strongly influence interpretation.
Limitations
Arrhythmia, missing ECG timing, poor long-axis segmentation, and inconsistent atrial boundary conventions can materially change atrial function. Disease interpretation should distinguish AF, HFpEF, valvular disease, and cardiomyopathy context.
Source audit
- Draft primer checked against the promoted Atrial structure and Atrial function pages.
- Atrial remodeling claims use literature-context references and disease badges as navigation only; they are not CardiacNexus AF classifiers.
docs/data/reference_sources.ymlexists and is the current registry for atrial clinical-context sources.- Textbook context boundary: broad Braunwald/Hurst atrial-fibrillation background was treated only as clinical context; the atrial page-specific literature is sufficient for draft interpretation context.
- Textbook route checked: Braunwald Atrial Fibrillation Clinical Features, Mechanisms, and Management, printed pages 173-192. It is not used as a phenotype threshold source; atrial measurements and method caveats remain grounded in CMR-specific sources.
References
- Peters DC, Lamy J, Sinusas AJ, Baldassarre LA. Left Atrial Evaluation by Cardiovascular Magnetic Resonance: Sensitive and Unique Biomarkers. European Heart Journal - Cardiovascular Imaging. 2022;23(1):14-30. PMID:34718484; PMCID:PMC8685602.
- Maceira AM, Cosin-Sales J, Roughton M, Prasad SK, Pennell DJ. Reference Left Atrial Dimensions and Volumes by Steady State Free Precession Cardiovascular Magnetic Resonance. Journal of Cardiovascular Magnetic Resonance. 2010;12(1):65. doi:10.1186/1532-429X-12-65.
- Bisbal F, Guiu E, Calvo N, Marin D, Berruezo A, Arbelo E, Ortiz-Perez J, De Caralt TM, Tolosana JM, Borras R, Sitges M, Brugada J, Mont L. Left Atrial Sphericity: A New Method to Assess Atrial Remodeling. Impact on the Outcome of Atrial Fibrillation Ablation. Journal of Cardiovascular Electrophysiology. 2013;24(7):752-759.