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Velocity distribution analysis and vortex size quantification by the Lambda2 (\u03bb<jats:sub>2<\/jats:sub>) method were performed in the LA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistics<\/jats:title><jats:p>Pearson or Spearman's correlation coefficients, <jats:italic>r<\/jats:italic>, were calculated to identify relationships between 4D flow\u2010derived LA parameters and age, LA\/LV function, and CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc stroke risk score. Univariate and multivariate determinants of stroke risk were assessed using linear regressions. To compare parameters within multiple groups, one\u2010way analysis of variance or Kruskal\u2013Wallis was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LA vortice sizes were observed in all subjects using \u03bb<jats:sub>2<\/jats:sub> showing inverse correlations with peak pulmonary vein inflow velocities (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), and positive correlations with LA volume (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Vortex size was elevated in PAF at all phases of the cardiac cycle, being most prominent at end early diastole (3.98\u2009\u00b1\u20091.84 cm<jats:sup>3<\/jats:sup> vs. 6.93\u2009\u00b1\u20093.11 cm<jats:sup>3<\/jats:sup>, <jats:italic>P<\/jats:italic> = 0.001). Velocity distribution analysis showed a greater incidence of flow stasis among patients with PAF (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). In univariate regression, vortex size was associated with the CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc risk score at peak systole (0.457\u2009\u00b1\u20090.038, <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.001). However, in multivariate regression age was the dominant determinant of stroke risk (0.348\u2009\u00b1\u20090.012, <jats:italic>P<\/jats:italic> = 0.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>This study demonstrated that LA vortex size is increased among low\u2010risk patients with PAF and is associated with the CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc risk score. Age remained the dominant determinant of stroke risk.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 2<\/jats:p><jats:p><jats:bold>Technical Efficacy:<\/jats:bold> Stage 3<\/jats:p><jats:p>J. Magn. Reson. Imaging 2020;51:871\u2013884.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26876","type":"journal-article","created":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T15:21:04Z","timestamp":1563895264000},"page":"871-884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Left atrial vortex size and velocity distributions by 4D flow MRI in patients with paroxysmal atrial fibrillation: Associations with age and CHA<sub>2<\/sub>DS<sub>2<\/sub>\u2010VASc risk score"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-8155","authenticated-orcid":false,"given":"Julio","family":"Garcia","sequence":"first","affiliation":[{"name":"Department of Cardiac Sciences University of Calgary  Calgary AB Canada"},{"name":"Department of Radiology University of Calgary  Calgary AB Canada"},{"name":"Stephenson Cardiac Imaging Centre University of Calgary  AB Canada"},{"name":"Libin Cardiovascular 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