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They can be assessed in vivo using 4D-flow-MRI; however, most studies involve clinical patient samples. We aimed to investigate demographic and cardiovascular (CV)-RF associations with LA and LAA hemodynamics in an observational study sample.<\/jats:p>\n <\/jats:sec>\n \n Material and methods<\/jats:title>\n Participants from the multi-ethnic study of atherosclerosis from our institution were approached to undergo cardiac MRI, including 4D-flow-MRI. LA and LAA volume, blood stasis (%voxel with velocity\u2009<\u20090.1\u2009m\/s), and peak velocity (PV, top 5% of voxels) were calculated. CV-RF (demographics, history of atrial fibrillation (AF), body mass index (BMI), etc.) were available through study records and investigated in multivariable linear regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n One hundred fifty-eight participants were included (age: 72.8\u2009\u00b1\u20097.3 years, 53% female). Higher age and AF were associated with lower PV\n LA<\/jats:sub>\n (\u03b2\n age<\/jats:sub>\n : \u22120.16,\n p<\/jats:italic>\n \u2009<\u20090.01; \u03b2\n AF<\/jats:sub>\n : \u22122.81,\n p<\/jats:italic>\n \u2009<\u20090.05) and higher LA stasis (\u03b2\n age<\/jats:sub>\n : 0.64,\n p<\/jats:italic>\n \u2009<\u20090.001; \u03b2\n AF<\/jats:sub>\n : 5.60,\n p<\/jats:italic>\n \u2009<\u20090.05). On the other hand, diabetes and left ventricular ejection fraction were associated with higher PV\n LA<\/jats:sub>\n (\u03b2\n diabetes<\/jats:sub>\n : 3.29,\n p<\/jats:italic>\n \u2009<\u20090.01; \u03b2\n LVEF<\/jats:sub>\n : 0.11,\n p<\/jats:italic>\n \u2009<\u20090.05), and diabetes was also associated with lower LA stasis (\u03b2: \u22126.12,\n p<\/jats:italic>\n \u2009<\u20090.05). PV\n LAA<\/jats:sub>\n was lower in Black participants (\u03b2: \u22122.64,\n p<\/jats:italic>\n \u2009<\u20090.01) and AF (\u03b2: \u22124.33,\n p<\/jats:italic>\n \u2009<\u20090.001). LAA stasis was lower in males (\u03b2: \u22125.36,\n p<\/jats:italic>\n \u2009<\u20090.01), white participants (\u03b2: \u22123.69,\n p<\/jats:italic>\n \u2009<\u20090.05), diabetes (\u03b2: \u22124.54,\n p<\/jats:italic>\n \u2009<\u20090.01) and higher BMI (\u03b2: \u22120.42,\n p<\/jats:italic>\n \u2009<\u20090.05) while higher LA volume (\u03b2: 0.12,\n p<\/jats:italic>\n \u2009<\u20090.01) was associated with higher LAA stasis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n We identified RF associated with impaired LA and LAA hemodynamics in an observational study cohort.<\/jats:p>\n <\/jats:sec>\n \n Key Points<\/jats:title>\n \n \n Question<\/jats:italic>\n <\/jats:bold>\n Are there associations of demographic and CV factors with impaired atrial hemodynamics from 4D-flow cardiac MRI<\/jats:italic>\n ?\n <\/jats:p>\n \n \n Findings<\/jats:italic>\n <\/jats:bold>\n 4D-flow MRI identified, amongst others, higher age, race, history of AF, and BMI in a sub-cohort of the Multi-Ethnic Study of Atherosclerosis<\/jats:italic>\n .\n <\/jats:p>\n \n \n Clinical relevance<\/jats:italic>\n <\/jats:bold>\n Understanding risk factor associations with atrial hemodynamics could aid in identifying subclinical atrial thrombus formation risks, potentially allowing for earlier preventive strategies against diseases such as stroke in diverse populations<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Graphical Abstract<\/jats:title>\n <\/jats:sec>","DOI":"10.1007\/s00330-025-11866-w","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T18:14:07Z","timestamp":1761848047000},"page":"3079-3090","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Demographic and cardiovascular risk factors associated with blood flow characteristics of the left atrium and left atrial appendage"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2449-7835","authenticated-orcid":false,"given":"Maurice","family":"Pradella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin J.","family":"Baraboo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley H.","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Maroun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia M.","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell A.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda L.","family":"DiCarlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth K.","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod","family":"Passman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Heckbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Greenland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Markl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"11866_CR1","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1161\/01.CIR.92.4.835","volume":"92","author":"EJ Benjamin","year":"1995","unstructured":"Benjamin EJ, D\u2019Agostino RB, Belanger AJ, Wolf PA, Levy D (1995) Left atrial size and the risk of stroke and death. 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J Magn Reson Imaging\u201d and \u201cPradella M et al (2024) Associations between 3D-based left atrial volumetric and blood flow parameters in a single-site cohort of the multi-ethnic study of atherosclerosis. Radiol Cardiothorac Imaging\u201d.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}