Assessment of left atrial volume by contrast enhanced magnetic resonance angiography

Left atrial (LA) volume is associated with cardiovascular morbidity, particularly atrial fibrillation. Contrast-enhanced magnetic resonance angiography (CE-MRA) visualizes the LA, but the validity of LA volume measurements using this technique has not been evaluated. We performed CE-MRA and cine magnetic resonance (MR) in 18 consecutive patients referred for CE-MRA prior to atrial fibrillation ablation. The CEMRA LA volumes were compared to cine MR LA volumes at the maximal LA size and at LA end-diastole using linear regression and limits of agreement analysis. The mean cine MR LA volume was 118 +/- 39 mL at maximal LA size and 91 +/- 38 mL at LA end-diastole. Left atrial volume determined by CE-MRA was 93 38 mL. Although the CE-MRA LA volume had a strong correlation with the maximal cine MR LA volume (R-2 = 0.86, p<0.001), the 95% limits of agreement were relatively wide (-54 to 3 mL). The cine MR LA end-diastolic and CE-MRA LA volumes were more closely correlated (R-2=0.98, P<0.001) with narrow 95% limits of agreement (-8 to 11 mL). The CE-MRA LA volumes correspond most closely to LA end-diastolic cine MR LA volumes and may be a useful measure of LA size.