Feasibility of left atrial and left ventricular strain assessment using CT feature tracking in patients with atrial fibrillation.

PURPOSE: To evaluate the feasibility of CT feature tracking (CT-FT) for assessing left atrial (LA) and left ventricular (LV) strain in atrial fibrillation (AF) patients, using 3T cardiac magnetic resonance (CMR) as the reference standard. METHODS: In this prospective single-center study, 30 patients were included in the final analysis. All participants underwent both coronary CT angiography (CCTA) and CMR examinations within 3 days before radiofrequency ablation. LA and LV strain parameters were measured using CT-FT, including LA reservoir strain (LASr), LV global longitudinal strain (LVGLS), LV global circumferential strain (LVGCS), and LV global radial strain (LVGRS). Conventional parameters, including LV end-diastolic volume, end-systolic volume, ejection fraction, and LA maximum volume, minimum volume, and emptying fraction, were also evaluated. CCTA-derived parameters werecompared withthe CMR using paired t test, Pearson or Spearman correlation coefficients, and Bland-Altman analysis. The reproducibility of CCTA measurements, including intraobserver and interobserver variability, was assessed using intraclass correlation coefficients (ICCs). RESULTS: CCTA yielded slightly lower values for strain parameters (LVGLS: 11.54 % vs 13.52 %; LVGCS: 11.65 % vs 13.44 %; LVGRS: 16.61 % vs 20.73 %; LASr: 18.04 % vs 19.85 %; all p < 0.05), yet correlations with CMR were excellent (r = 0.85-0.96, all p < 0.001). The conventional parameters showed no statistically significant differences between CCTA and CMR measurements (all p > 0.05), with excellent correlations (r = 0.93-0.99, p < 0.001). CCTA measurements exhibited high intraobserver and interobserver reproducibility (ICC > 0.75 for all). CONCLUSION: CT-FT showed strong correlations with CMR and good reproducibility for assessing LV and LA strain in patients with AF, supporting its feasibility as a complementary method for comprehensive cardiac functional assessment.