Peak atrial longitudinal strain (PALS): better call it stretch?

Abstract

Left atrial (LA) strain is gaining more and more relevance in medical literature, with many applications in different clinical setting. The term “strain”, meaning deformation, is applied to the contraction phase of the left ventricle (LV), due to its myocardial shortening along the longitudinal axis, to the LA relaxation phase, correlated to its distensibility and elastic compliance in receiving blood from the pulmonary veins, and even to LA contraction consequent to the electric activation of LA myocardium. This manuscript describes main anatomical and physiological characteristic of the left atrium and discusses the use of the term strain from terminological and conceptual points of view.

One‐hour post‐load glucose and subclinical left atrial myocardial dysfunction in hypertensive patients

“…7 The three main atrial phases during cardiac cycle (reservoir, conduit and pump) can be also evaluated by speckle tracking echocardiography STE, which is a new method of non-invasive semi-automatic advanced echocardiographic analysis that allows the assessment of regional and global myocardial deformation of both ventricles and atria. 8 LA strain can be accurately measured during three atrial function phase and it is referred as peak atrial contraction strain (PACS) which represents the pump phase, peak atrial longitudinal strain (PALS), which represents the reservoir phase, the changes during LV systole 9 and the conduit phase when blood flows directly from pulmonary veins to LV.…”

“…LA strain can be accurately measured during three atrial function phase and it is referred as peak atrial contraction strain (PACS) which represents the pump phase, peak atrial longitudinal strain (PALS), which represents the reservoir phase, the changes during LV systole 9 and the conduit phase when blood flows directly from pulmonary veins to LV.…”

Acute Left Atrial Response to Different Eccentric Resistance Exercise Loads in Patients with Heart Failure with Middle Range Ejection Fraction: A Pilot Study

“…The left atrium is a hemodynamic mediator between LV and pulmonary circulation. It contributes to LV filling and protects the pulmonary capillary bed from pressure and volume overloads [ 17 ]. Therefore, investigating LA dynamics during exercise plays a pivotal role in the understanding of mechanisms of exercise intolerance in HF patients and can help to find more suitable exercise protocols for training these patients.…”