Biatrial and right ventricular deformation imaging: Implications of the recent EACVI consensus document in the clinics and beyond

Abstract

In this review, right ventricular (RV), right atrial (RA), and left atrial (LA) strain in some selected clinical situations has been discussed in light of the current literature. To exemplify the significance of the use of multichamber strain, we have provided some illustrations of common cardiac problems. The recently published European Association of Cardiovascular Imaging (EACVI) consensus document for standardization of RV, RA, and LA strain, using the currently available software, has fulfilled the aspirations of investigators world over who have been studying atrial strain using a bailed‐out algorithm designed principally to quantify left ventricular deformation. The purpose of this review was to reiterate the value of the application of RV and biatrial strain imaging in research and day‐to‐day clinical practice, using the 2‐dimensional speckle tracking echocardiography (2D‐STE). Also, we present a short report on how RA strain may remain coupled to pulmonary hemodynamics. Besides, we have highlighted the technical challenges of atrial strain quantification. We have not used the nomenclature of chamber deformation proposed by the EACVI document as the publications cited in this review have used different sets of nomenclature.

Progress of clinical application of speckle tracking echocardiography in Transcatheter Aortic Valve Implantation or Transcatheter Aortic Valve Replacement

“…Like the left atrium, RA deformation is a cyclic process, which can be sub-divided into three phases: the Reservoir phase, the Conduit phase and the Contraction phase. [40,50] Early impairment of left ventricular diastolic function will lead to significant reduction in right atrial and right ventricular strains. Vakilian et al [51] studied the non-invasive assessment of right ventricular hemodynamics in patients with heart failure (HFrEF) with reduced ejection fraction using right atrial strain.…”

Echocardiographic diagnosis of cardiac amyloidosis: Does the masquerader require only a "cherry on top"?

“…As shown in Figure 1, bi‐atrial and right ventricular strain may provide useful diagnostic measures complementing the standard echo‐Doppler data. All the suggested cardiac comorbidities associated with CA, such as aortic stenosis, 1 atrial fibrillation, 2 and heart failure with preserved ejection fraction, have been shown to have diagnostic values using bi‐atrial and right ventricular strain 13 …”

Echocardiography 2020: Toward deciphering the “Rosetta stone” of left ventricular diastolic function

“…Not only that, in moderate to severe valvular pathologies, an abnormal diastolic stress test (elevated LAP, RVSP, E/Eʹ ratio, alone or in combination) may also offer convincing arguments in favor of early intervention. In subjects with moderate to severe aortic stenosis, an exercise‐induced elevated LAP or RVSP may be considered as “collateral damage,” prompting an early replacement of the diseased valve 10 Probably, the simplest of stress procedure could be a passive leg raise maneuver bedside, as has been illustrated in one of the contributions in this special issue by Henein and Lindqvist 11 …”