Left Atrial Fractional Shortening: A Simple and Practical “Strain” for Everyone

Abstract

Background: The function of the left atrium (LA) is reduced in many cardiac diseases even with normal size. The assessment of its compliance could represent an added value in an echocardiographic report in case the gold standard technique (speckle-tracking echocardiography [STE]) is not available. We sought to test a simple and quick method as surrogate of STE: the dynamic measurement of the LA anteroposterior diameter (APD) that we called LA fractional shortening (LAFS). Materials and Methods: A total of 153 consecutive patients underwent a transthoracic echocardiography in our echo laboratory between January and June 2017. The only inclusion criteria were the presence of an acoustic window and the informed consent. We chose to not apply exclusion criteria to assess LAFS feasibility. The LAFS was calculated as (maxAPD−minAPD)/(maxAPD) × 100 in parasternal long-axis view. We evaluated the correlation of its value with the peak atrial longitudinal strain (PALS) and the LA emptying fraction (EF). Results: Mean execution time was 32.1 ± 5 s for LAFS, 2.3 ± 0.7 min for LAEF, and 2 ± 1 min for PALS. LAFS, with a feasibility of about 97%, was moderately correlated with PALS and LAEF (R between 0.20 and 0.30, P < 0.05). LAFS fractional shortening also emerged as surrogate for PALS via the relationship PALS = 21.07 + 0.364x (LAFS). Conclusions: LAFS demonstrated a correlation with PALS, a short execution time, a high feasibility, and the possibility to be used as a surrogate of PALS, applying a specific formula.

Incidence, Risk Factors, and Outcomes of Left Atrial Enlargement in Patients Requiring Right Ventricular Pacing: A Retrospective Study of 461 Cases from 2012 to 2020

“…The LA plays a major role in cardiac physiology by collecting blood during systole and modulating LV filling during diastole, which can lead to overloading of LA pressure or volume, due to diastolic dysfunction or MR [ 26 , 27 ]. The common method for assessing LA size is to measure its anteroposterior linear dimension using M-mode or 2-dimensional echocardiography in the parasternal long-axis view by transthoracic echocardiography [ 28 ]. Although the anteroposterior diameter of the LA is considered inaccurate and may not fully represent the actual LA size, this assessment method is widely used and is highly reproducible [ 29 ].…”

Predictive Value of Left Atrial and Ventricular Strain for the Detection of Atrial Fibrillation in Patients With Cryptogenic Stroke

“…Since the substrate for AF relates to left atrial (LA) dilation and fibrosis, with subsequent structural and electrophysiological remodeling, dysfunction, and delay in electromechanical conduction ( 11 ), echocardiographic parameters investigating LA size and function are gaining growing interest as a surrogate predictor of hidden AF ( 12 , 13 ), even more so in patients with CS ( 14 , 15 ). Moreover, the assessment of LV diastolic parameters and compliance, also affecting LA size and function ( 16 – 18 ), can be of relevance in this setting ( 19 , 20 ).…”