“…In this context, LALS might be a sensitive marker of preclinical insult, translating diastolic impairment and a rise in filling pressures [ 33 , 34 ], as shown in children [ 27 , 28 ]. Atrial strain has emerged as a sensitive tool in early detection of subtle or early changes in the setting of various cardiac conditions such as atrial fibrillation, valvulopathies, systemic diseases, heart failure with preserved ejection fraction and diastolic dysfunction [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. LALS changes usually precede other structural variations such as left atrial volume increase and systolic dysfunction in heart failure.…”