{
  "abstract": "Background: Cardiovascular magnetic resonance (CMR) imaging allows simultaneous evaluation of cardiac structure, function, and tissue composition. Whether CMR-derived left atrial (LA) reservoir strain, the left atrial volume index–left ventricular ejection fraction (LAVI/LVEF) ratio, and atrial late gadolinium enhancement (LGE) can identify patients at risk for 30-day readmission after atrial fibrillation (AF)–related hospitalisation has not been investigated.\n\nObjectives: This study aims to evaluate the association between CMR parameters and 30-day unplanned readmission following an AF-related index admission and to describe CMR differences across three clinical groups using a three-group cohort design.\n\nMethods: This retrospective cohort study at Chulabhorn Hospital, Bangkok (IRB005/2569), enrolled 43 patients with AF who underwent CMR on 1.5 T or 3 T Philips scanners: 25 outpatients (OPD), 10 index-admitted patients without readmission (Adm-NoReadmit), and 8 index-admitted patients with 30-day unplanned readmission (Readmit). A CMR analysis was performed using CVI42 version 6.4. LA reservoir strain was derived by feature tracking from standard cine images.\n\nResults: Among the admitted patients ( n = 18), LA reservoir strain showed the highest apparent discrimination for readmission [area under the curve (AUC), 0.963; p < 0.001; exploratory internally derived cutpoint <11.1%: sensitivity, 88%; 95% confidence interval (CI), 47%–100%; specificity, 100%; 95% CI, 69%–100%]. Correcting for predictor selection, the optimism-corrected AUC was 0.919. The LAVI/LVEF ratio was also associated with readmission (AUC, 0.913; p = 0.002). Qualitative atrial hyperenhancement on non-dedicated LGE imaging completely separated readmitted from non-readmitted admitted patients (8/8 vs. 0/10); however, because it was assessed on an LV-optimised protocol not validated for atrial tissue, we report it only as an exploratory qualitative finding and do not interpret it as evidence of a fibrosis mechanism. The LACE score (length of stay, acuity of admission, Charlson comorbidity index, and emergency department visits) achieved an AUC of 0.719 (95% CI, 0.44–0.95; p = 0.125); an exploratory combined LACE+ LA reservoir strain model produced a numerically higher apparent AUC, but with only eight events, this estimate is unstable and likely overfitted and is not interpreted as evidence of incremental value. A three-group analysis revealed a non-monotonic pattern: The Adm-NoReadmit patient group had the highest LA reservoir strain (15.4%), exceeding the OPD group (8.5%), whereas the Readmit group had the lowest (6.6%).\n\nConclusion: In this exploratory feasibility analysis, CMR-derived LA reservoir strain and the LAVI/LVEF ratio were associated with 30-day unplanned readmission following an AF-related index admission. Because readmitted patients had a substantially higher prevalence of heart-failure history, these associations may reflect a shared structural–functional substrate rather than independent, AF-specific effects. Descriptive comparison across the three clinical groups showed a non-monotonic LA functional pattern, suggesting that CMR may aid risk stratification at discharge. However, prospective validation is needed.",
  "abstract_shown": true,
  "affiliations": [
    "Princess Srisavangavadhana Faculty of Medicine, Chulabhorn Royal Academy",
    "Department of Cardiovascular Medicine, Chulabhorn Hospital",
    "Department of Radiology, Chulabhorn Hospital",
    "Department of Cardiology, Chulabhorn Hospital"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Maethas Panyawongkhanti"
    },
    {
      "affs": [
        2
      ],
      "name": "Anuchai Fueangtalop"
    },
    {
      "affs": [
        1
      ],
      "name": "Nattanon Satitthammaphon"
    },
    {
      "affs": [
        3
      ],
      "name": "Chokanan Thaitirarot"
    },
    {
      "affs": [
        1
      ],
      "name": "Viroj Mueangsilpsat"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Chanwit Wuttichaipradit"
    },
    {
      "affs": [
        1
      ],
      "name": "Anusith Tunhasiriwer"
    },
    {
      "affs": [
        1
      ],
      "name": "Chonthicha Tanking"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5yckzsn5jzbrr.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1845659",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727458/?tool=EBI",
  "id": "5yckzsn5jzbrr",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1845659/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7223028145",
  "pdf_url": "https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2026.1845659/pdf",
  "pmcid": "PMC13727458",
  "pmid": "42978673",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5yckzsn5jzbrr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1845659",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1845659/full"
    },
    {
      "first_seen": "2026-11-04T15:20:45Z",
      "native_id": "PMC:PMC13727458",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727458"
    },
    {
      "first_seen": "2026-11-06T12:23:20Z",
      "native_id": "PMC13727458",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fcvm.2026.1845659"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "CMR-derived left atrial reservoir strain and the LAVI/LVEF ratio are associated with 30-day readmission in atrial fibrillation: the CMRRADAR-AF retrospective cohort study",
  "title_text": "CMR-derived left atrial reservoir strain and the LAVI/LVEF ratio are associated with 30-day readmission in atrial fibrillation: the CMRRADAR-AF retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:38Z",
  "url": "https://research.draconitic.com/paper/5yckzsn5jzbrr",
  "venue": "Frontiers in Cardiovascular Medicine",
  "versions": []
}