Purpose. The peculiarities of left atrial (LA) structure in healthy population and in cardiovascular disease according to late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) are of current interest. This study analyzed differences in LA patchy LGE between healthy volunteers (HV) and patients with atrial fibrillation (AF) or hypertension. Methods 53 patents with AF (mean age 56 years, 60% men), 25 patients with hypertension and no history of AF (mean age 54 years, 40% men), 28 HV (mean age 50 years, 52% men) were enrolled in the study. LA patchy LGE quantification was performed using LGE MRI (1.5 T scanner, voxel size 1.25x1.25x2.5 mm) and the special-built software based on estimation of LA voxel image intensity ratio and comparison with threshold value obtained from HV data. Results Patients with AF had a higher extent of LA patchy LGE (9.1 [1.72; 18.58] %) than patients with hypertension (3.81 [0.57; 9.51] %) and HV (0.78 [0.05; 3.5] %). The predominant location of LA patchy LGE in AF was the pulmonary vein ostia region, in hypertension – LA posterior wall, in HV – lower part of LA posterior wall. In AF the extent of LA patchy LGE correlated with LA end diastolic volume (r=0.37, P<0.001) and LA ejection fraction (r=-0.4, P<0.001), in HV – with age (r=0.66, P<0.001), LA end diastolic volume (r=0.4, P=0.04). Conclusions AF and hypertension seem to be associated with higher extent and different location of LA patchy LGE than natural aging. The extent of LA patchy enhancement correlates with LA dilatation.