Normal Ranges of Left Atrial Strain by Speckle-Tracking Echocardiography: A Systematic Review and Meta-Analysis

Pathan, Faraz; D’Elia, Nicholas; Nolan, Mark; Marwick, Thomas H.; Negishi, Kazuaki

doi:10.1016/j.echo.2016.09.007

Cited by 383 publications

(319 citation statements)

References 70 publications

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“…We choose for strain rate to assess LA booster pump function instead of peak strain, as this was found to be superior . Pathan et al performed a meta‐analysis to formulate normal values for LA function. Reservoir function was 39.4% which corresponds very well with our findings, unfortunately for conduit and pump function, strain instead of strain rate was used, which makes it impossible to compare our findings.…”

Section: Discussionmentioning

confidence: 99%

In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis

et al. 2018

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Purpose Left atrial ( LA ) dilatation is predictive for complications in a multitude of cardiac diseases; therefore, adequate assessment is essential. Technological advances have made it possible to quantify LA function with Speckle Tracking Echocardiography ( STE ); however, there are currently no recommendations for normal values with regard to LA function. We aimed to assess LA myocardial and volumetric function in a healthy cohort and investigate correlations with baseline characteristics. Methods This prospective cohort study included 147 (aged 20–72) healthy individuals and assessed LA volumetric function using maximum, minimum and pre‐a‐wave volumes and myocardial function using reservoir function using peak strain in LA relaxation ( LA ‐strain), conduit function using peak strain rate in early LA contraction ( LA ‐ SR e) and pump function using peak strain rate in late LA contraction ( LA ‐ SR a). Results Mean LA ‐strain was 39.7 ± 6.2%, LA ‐ SR e −2.78 ± 0.62 s −1 and LA ‐ SR a −2.56 ± 0.62 s −1 . Subjects were divided into 5 age decades (each 50% female). LA ‐strain and LA ‐ SR e were lower in the oldest groups, whereas LA ‐ SR a was higher. LA ‐ SR a was higher in males(−2.69 ± 0.68 s −1 vs −2.42 ± 0.52 s −1 ). Age‐specific values are provided. Age proved to be an independent predictor for LA ‐ SR a after correction for blood pressure and heart rate. LA expansion index and passive emptying fraction decreased with age, while active emptying fraction increased with age. LA maximum volume did not increase with age. Conclusion This study provides normal values for the three phasic functions of the LA , assessed with STE and volumetric function. Our results suggest the need for age‐specific reference ranges, and normal values for this cohort have been calculated.

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Section: Discussionmentioning

confidence: 99%

In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis

et al. 2018

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“…Furthermore, long‐term follow‐up of 1375 patients with normal LV systolic function showed that a baseline LAVi above ≥32 mL/m 2 is an independent predictor for the development of congestive heart failure. It has been also demonstrated to have a better predictive value in the prediction of postoperative AF development as compared to left ventricular global strain and ejection fraction …”

Section: Discussionmentioning

confidence: 99%

“…As changes in pressure and volume are frequently observed in patients with end‐stage renal failure, the structure and functions of the left atrium are disturbed in these patients. Although the pressure overload and volume overload are attempted to be balanced through dialysis, this is often not enough to prevent potential morphological and functional changes in the ventricle and atrium …”

Section: Introductionmentioning

confidence: 99%

The effect of dialysis type on left atrial functions in patients with end‐stage renal failure: A propensity score‐matched analysis

Aksu

Gülcü

et al. 2017

Echocardiography

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“…Moreover, in HFpEF a diastolic stress test by echocardiography could be indicated in case of uncertainty, to evaluate LV filling pressure and pulmonary artery pressure during effort . Recently, speckle‐tracking echocardiography has been used to evaluate regional and global LA function . Atrial strain is studied in multiple cardiovascular disorders including hypertension, diabetes, HF and AF .…”

Section: Integrated Imaging Evaluation For Decision Makingmentioning

confidence: 99%

The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction

et al. 2017

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SummaryAim: Functional analysis and measurement of left atrium are an integral part of cardiac evaluation, and they represent a key element during non-invasive analysis of diastolic function in patients with hypertension (HT) and/or heart failure with preserved ejection fraction (HFpEF). However, diastolic dysfunction remains quite elusive regarding classification, and atrial size and function are two key factors for left ventricular (LV) filling evaluation. Chronic left atrial (LA) remodelling is the final step of chronic intracavitary pressure overload, and it accompanies increased neurohormonal, proarrhythmic and prothrombotic activities. In this systematic review, we aim to purpose a multi-modality approach for LA geometry and function analysis, which integrates diastolic flow with LA characteristics and remodelling through application of both traditional and new diagnostic tools. Methods:The most important studies published in the literature on LA size, function and diastolic dysfunction in patients with HFpEF, HT and/or atrial fibrillation (AF) are considered and discussed. Results:In HFpEF and HT, pulsed and tissue Doppler assessments are useful tools to estimate LV filling pressure, atrio-ventricular coupling and LV relaxation but they need to be enriched with LA evaluation in terms of morphology and function. An integrated evaluation should be also applied to patients with a high arrhythmic risk, in whom eccentric LA remodelling and higher LA stiffness are associated with a greater AF risk. Conclusion:Evaluation of LA size, volume, function and structure are mandatory in the management of patients with HT, HFpEF and AF. A multi-modality approach could provide additional information, identifying subjects with more severe LA remodelling.Left atrium assessment deserves an accurate study inside the cardiac imaging approach and optimised measurement with established cut-offs need to be better recognised through multicenter studies.

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Normal Ranges of Left Atrial Strain by Speckle-Tracking Echocardiography: A Systematic Review and Meta-Analysis

Cited by 383 publications

References 70 publications

In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis

In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis

The effect of dialysis type on left atrial functions in patients with end‐stage renal failure: A propensity score‐matched analysis

The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction

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