Left atrial regional phasic strain, strain rate and velocity by speckle-tracking echocardiography: Normal values and effects of aging in a large group of normal subjects

Sun, Jing Ping; Yang, Ying; Guo, Ruru; Wang, Dian; Lee, Alex; Wang, Xiao Yan; Lam, Yat‐Yin; Fang, Fang; Yang, Xing Sheng; Yu, Cheuk‐Man

doi:10.1016/j.ijcard.2013.04.167

Cited by 84 publications

(95 citation statements)

References 18 publications

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“…In addition, the obtained images were of sufficient quality to allow STE analysis, both in dogs with a structurally normal LA and in dogs with an enlarged LA. Similar data have been reported in healthy people, where adequate tracking quality was achieved in >95% of segments analyzed and inter‐ and intra‐observer variability coefficients of measurements ranged approximately between 3% and 6% 13, 37. The CV relative to LAAmax, LAAmin and FAC were slightly lower than those obtained for the STE variables (PALS, PACS, and CSI).…”

Section: Discussionsupporting

confidence: 84%

“…Contraction strain index, a parameter indicative of LA active systolic function, showed a transient increase from dogs of group A to those of group B1 followed by a progressive reduction. This supernormal pattern has already been observed in humans with mild MR, and it is likely secondary to Starling's law usually applied to the ventricles 37. In fact, the atria also enhance their contractile function in response to an increased preload during the early phase of MR, but this function subsequently declines as the LV filling pressure increases 37…”

Section: Discussionmentioning

confidence: 60%

See 1 more Smart Citation

Assessment of Left Atrial Deformation and Function by 2‐Dimensional Speckle Tracking Echocardiography in Healthy Dogs and Dogs With Myxomatous Mitral Valve Disease

Toaldo

Romito

Guglielmini

et al. 2017

Veterinary Internal Medicne

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BackgroundThe assessment of left atrial (LA) function by 2‐dimensional speckle tracking echocardiography (STE) holds important clinical implications in human medicine. Few similar data are available in dogs.ObjectivesTo assess LA function by STE in dogs with and without myxomatous mitral valve disease (MMVD), analyzing LA areas, systolic function, and strain.AnimalsOne hundred and fifty dogs were divided according to the American College of Veterinary Internal Medicine classification of heart failure: 23 dogs in class A, 52 in class B1, 36 in class B2, and 39 in class C + D.MethodsProspective observational study. Conventional morphologic and Doppler variables, LA areas, and STE‐based LA strain analysis were performed in all dogs and results were compared among groups. Correlation analysis was carried out between LA STE variables and other echocardiographic variables.ResultsVariability study showed good reproducibility for all the tested variables (coefficient of variation <16%). Left atrial areas, fractional area change, peak atrial longitudinal strain (PALS), peak atrial contraction strain, and contraction strain index (CSI) differed significantly between groups B2 and C + D and all the other groups (overall P < .001), whereas only PALS differed between groups B1 and A (P = .01). Left atrial areas increased with progression of the disease, whereas LA functional parameters decreased. Only CSI increased nonsignificantly from group A to group B1 and then progressively decreased. Thirty‐one significant correlations (P < .001, r > .3) were found between conventional left heart echocardiographic variables and LA areas and strain variables.Conclusions and Clinical ImportanceLeft atrial STE analysis provides useful information on atrial function in the dog, highlighting a progressive decline in atrial function with worsening of MMVD.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 60%

Assessment of Left Atrial Deformation and Function by 2‐Dimensional Speckle Tracking Echocardiography in Healthy Dogs and Dogs With Myxomatous Mitral Valve Disease

Toaldo

Romito

Guglielmini

et al. 2017

Veterinary Internal Medicne

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“…The authors found higher strain values in women than in men and a decrease of peak left and right atrial strain with age, findings generally in line with the literature, 8,9 and new for the right atrium. Time-to-peak strain measurements from all chambers are also reported.…”

Section: See Article By Addetia Et Alsupporting

confidence: 88%

“…From Figure 1 of Addetia et al (the only one with an electrocardiographic tracing), it seems that LV and left atrial strain curves both start at zero at the end of the electrocardiographic QRS complex. However, physiologically, left atrial (LA) expansion in sinus rhythm starts at the onset or even before the QRS complex 5,7 (see Figure), and LV longitudinal shortening also starts during QRS.The authors found higher strain values in women than in men and a decrease of peak left and right atrial strain with age, findings generally in line with the literature, 8,9 and new for the right atrium. Time-to-peak strain measurements from all chambers are also reported.…”

supporting

confidence: 78%

Simultaneous 4-Chamber Strain

Baron

Flachskampf

2016

Circ: Cardiovascular Imaging

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A nalysis of myocardial deformation, or strain imaging, is becoming part of routine echocardiography. 1 The most widely accepted parameter to date has been global longitudinal strain as a measure of global left ventricular (LV) function. Global longitudinal strain (LS) of the LV, in (negative) percent, is the average of the maximal shortening (in percent) in the apicobasal direction of each of 18 LV segments visualized in the 3 standard apical views. The strain curves are computed using speckle tracking to determine myocardial velocity in a region of interest from which local strain is derived. LS is defined as deformation (shortening or lengthening) along the midline of LV walls, that is, in an apico-basal direction, but following the curvature of the LV walls.2 Similarly, global left or right atrial or right ventricular LS can be obtained as average of segmental peak LS. Strain data are highly dependent on image quality and frame rate, as well as physiological parameters as blood pressure. See Article by Addetia et alThe article of Addetia et al 3 in this issue of Circulation: Cardiovascular Imaging explores LS values from all 4 chambers obtained simultaneously from the 4-chamber view of the same cardiac cycle using a software (Epsilon Imaging, Ann Arbor MI) that can accommodate data acquired with echo machines from different echo manufacturers, although for this article, only echos acquired with one brand of echo machines were used. LS analysis was based on speckle tracking in 21 segments per patient (6 for the LV, 3 for the right ventricle, and 6 each for left and right atrium, using the same 3 septal segments for both); for each chamber, a global strain curve was calculated by averaging the segmental LS of the pertinent segments. Less than 1% of segments were excluded because of bad quality, which is a remarkably high success rate. For unclear reasons, the size of individual segments presented in Figure 1 of Addetia et al is somewhat variable, most conspicuously for the small basal right ventricular free wall segment. Global peak LS and heart rate-corrected time-topeak LS were measured for each chamber, and data from 259 healthy individuals, stratified by sex and age, are presented.Peak LV LS values, calculated from the 6 segments of the 4-chamber view, were −18±2%. This is lower than a recent meta-regression from the published literature reported for classic global LS (calculated from the 18 segments of the 3 apical views), namely −19.7%; 95% confidence interval, −20.4% to −18.9%. 4 Although the reduction compared with published values may seem low, 1.7% absolute percent difference corresponds to 9% relative change. Because strain measurements are typically used to detect small, subtle, subclinical changes, this is not a negligible difference.Peak left atrial strain values reported in the study of Addetia (+38±13%) are close to the published values. 5,6 For the right ventricular free wall, a normal range of −23±6% was found, again lower than currently recommended normal values from (−29±4.5%).1 Given the s...

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“…In the last years, normative data on new indices of STE data have become available for the LV (60,61,63,66,67), the RV (72,73), the LA (68)(69)(70)74,77,79), and the RA (70)(71)(72)(73)(74)(75)(76)(77)(78). Some of the most recent publications evaluated 3D STE parameters (61,72,95), while data on twist and untwist are still limited (60).…”

Section: Deformation Analysismentioning

confidence: 99%

Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values

Cantinotti¹,

Giordano²,

Paterni³

et al. 2017

J. Thorac. Dis.

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There is a crescent interest on normal adult echocardiographic values and the introduction of new deformation imaging and 3D parameters pose the issue of normative data. A multitude of nomograms has been recently published, however data are often fragmentary, difficult to find, and their strengths/ limitations have been never evaluated. Aims: (I) to provide a review of current echocardiographic nomograms; (II) to generate a tool for easy and fast access to these data. A literature search was conducted accessing the National Library of Medicine using the keywords: 2D/3D echocardiography, strain, left/ right ventricle, atrial, mitral/tricuspid valve, aorta, reference values/nomograms/normal values. Adding the following keywords, the results were further refined: range/intervals, myocardial velocity, strain rate and speckle tracking. Forty one published studies were included. Our study reveals that for several of 2D/3D parameters sufficient normative data exist, however, a few limitations still persist. For some basic parameters (i.e., mitral/tricuspid/pulmonary valves, great vessels) and for 3D valves data are scarce. There is a lack of studies evaluating ethnic differences. Data have been generally expressed as mean values normalised for gender and age instead of computing models incorporating different variables (age/gender/body sizes) to calculate z scores. To summarize results a software (Echocardio-Normal Values) who automatically calculate range of normality for a broad range of echocardiographic measurements according to age/gender/weight/ height, has been generated. We provide an up-to-date and critical review of strengths/limitation of current adult echocardiographic nomograms. Furthermore we generated a software for automatic, easy and fast access to multiple echocardiographic normative data.

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Left atrial regional phasic strain, strain rate and velocity by speckle-tracking echocardiography: Normal values and effects of aging in a large group of normal subjects

Cited by 84 publications

References 18 publications

Assessment of Left Atrial Deformation and Function by 2‐Dimensional Speckle Tracking Echocardiography in Healthy Dogs and Dogs With Myxomatous Mitral Valve Disease

Assessment of Left Atrial Deformation and Function by 2‐Dimensional Speckle Tracking Echocardiography in Healthy Dogs and Dogs With Myxomatous Mitral Valve Disease

Simultaneous 4-Chamber Strain

Adult echocardiographic nomograms: overview, critical review and creation of a software for automatic, fast and easy calculation of normal values

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