Left atrial function: evaluation by strain analysis

Gan, G.; Ferkh, A.; Boyd, Anita; Thomas, Liza

doi:10.21037/cdt.2017.06.08

Cited by 137 publications

(127 citation statements)

References 140 publications

(149 reference statements)

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“…Previous research has highlighted the prognostic and clinical values of the LA and RA functions as evaluated with 2D speckle‐tracking echocardiography in some conditions . Two‐dimensional speckle‐tracking echocardiography is an assessment method for atrial functions and can detect atrial dysfunction, however subtle …”

Section: Discussionmentioning

confidence: 99%

“…The difference between the plateau phase strain and the contraction phase strain, namely, the contraction phase strain (late diastolic strain), is considered a parameter of the atrial contraction. In the strain rate curves, it appears as a negative peak in late diastole (late diastolic strain rate; Figure ) …”

mentioning

confidence: 99%

“…In the strain rate curves, it appears as a negative peak in late diastole (late diastolic strain rate; Figure 1). 11,12 The parameters derived from the assessment of the longitudinal deformation of the atrial walls and accepted as the indices of the atrial functions can be obtained by 2 methods: 2-dimensional (2D) speckle-tracking echocardiography and color-coded tissue Doppler echocardiography. The foremost limitation of color-coded tissue Doppler echocardiography is its angle dependency.…”

mentioning

confidence: 99%

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Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Haji-Zeinali

Iri

Hosseinsabet

2018

J of Ultrasound Medicine

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Objectives The available literature lacks data on the comparison of the functions of the right atrium (RA) and left atrium (LA) between surgical atrial septal defect (ASD) closure and percutaneous device ASD closure at follow‐up durations of longer than 1 year. We sought to evaluate the RA and LA functions in patients who underwent surgical or device ASD closure between 1 and 5 years postprocedurally. Methods The study population included 30 patients who underwent device ASD closure and 30 who underwent surgical ASD closure, who were matched for the procedural time, age, and sex, in addition to 30 control participants. The RA and LA functions were evaluated with 2‐dimensional speckle‐tracking echocardiography. Results The LA systolic and early diastolic strain and strain rate values and the RA early diastolic strain rate in the device closure group were more likely to be abnormal than in the control group. The RA systolic and late diastolic strain and strain rate values, the RA early diastolic strain rate, and the LA early diastolic strain in the surgical closure group were more likely to be abnormal than in the control group. The RA systolic strain and strain rate in the surgical closure group were more likely to be abnormal than in the device closure group. Conclusions The LA reservoir and conduit functions and the RA contraction function in the patients who underwent device ASD closure and all of the RA functions and the LA conduit function in the patients who underwent surgical ASD closure were more likely to be abnormal than those in the control participants. The RA reservoir function in the surgical closure group was more likely to be abnormal than that in the device closure group.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Haji-Zeinali

Iri

Hosseinsabet

2018

J of Ultrasound Medicine

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“…The LA strain and strain rate parameters are less load dependent in the evaluation of atrial functions than conventional echocardiographic methods. However, the lack of specific guidelines on the standardized measurement of these parameters and the lack of specific software for LA assessment are important limitations of studies . Furthermore, it is time consuming and increases the cost to perform advanced echocardiographic methods on all patients with suspected PAF.…”

Section: Discussionmentioning

confidence: 99%

“…However, the lack of specific guidelines on the standardized measurement of these parameters and the lack of specific software for LA assessment are important limitations of studies. 21 Furthermore, it is time consuming and increases the cost to perform advanced echocardiographic methods on all patients with suspected PAF. According to our study, a TMAW-AccT of longer than 82 ms during the standard echocardiographic evaluation in patients with suspected PAF predicted PAF with a sensitivity of 65.7% and a specificity of 64.3%.…”

Section: F I G U R E 2 Measure Of Transmitral Awave Acceleration Timementioning

confidence: 99%

Predictive value of transmitral A‐wave acceleration time for paroxysmal atrial fibrillation

et al. 2019

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Background It has been shown that transmitral A‐wave (TMAW) is affected in paroxysmal atrial fibrillation (PAF), and decreased left atrial contractions cause a decrease in the TMAW velocity. The relationship between TMAW acceleration time (TMAW‐AccT) and PAF is unknown. In this study, the predictive value of TMAW‐AccT for PAF was investigated. Methods Seventy PAF patients (mean age: 57.8 ± 11.0 years) and 70 control patients (mean age: 58.1 ± 10.5 years) were included in the study. Transthoracic echocardiography was performed in sinus rhythm in all patients. For TMAW‐AccT, the time between the basal point of the A‐wave and the highest point reached was measured. Results Transmitral A‐wave ‐AccT was significantly longer in the PAF group than the control group (TMAW‐AccT; 88.5 ± 18.1 vs 77.2 ± 16.4 ms, P = .000, respectively). The left atrial diameter and the left atrial volume index were similar between the groups (P = .07, P = .18, respectively). According to a multivariate logistic regression analysis, the TMAW‐AccT (OR: 1.02, 95% confidence interval 1.02–1.07, P < .001) was a predictor of PAF. A receiver operating characteristic curve analysis showed a cutoff value of TMAW‐AccT of >82 ms (sensitivity: 65.7%, specificity: 64.3%, positive predictive value: 64.8%, negative predictive value: 65.2%). Conclusion Transmitral A‐wave‐AccT can be used as an early marker in detecting PAF without dilated left atrium.

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Left atrial global function in chronic heart failure patients with functional mitral regurgitation after MitraClip

Öztürk

Fasell

Sinning

et al. 2020

Cathet Cardio Intervent

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Background Left atrial (LA) volumes and function are believed to improve following interventional reduction of mitral regurgitation (MR) with MitraClip. However, exact LA alterations after MitraClip in patients with functional MR and functional mitral regurgitation (FMR) are unknown. Objectives We aimed to evaluate the effect of MitraClip on LA volumes and global function in patients with FMR and its importance for patients' prognosis. Methods All patients underwent three‐dimensionally transthoracic echocardiography with an offline evaluation of LA geometry and strain analysis at baseline and follow‐up (FU). FU examinations were planned for 6 and 12 months after MitraClip. Results We prospectively included 50 consecutive surgical high‐risk (logistic EuroSCORE: 17.2 ± 13.9%) patients (77 ± 9 years, 22% female) with symptomatic moderate‐to‐severe to severe functional MR without atrial fibrillation. Echocardiographic evaluation showed that the E/E' ratio was significantly higher at FU (15.6 ± 7.3, 24.1 ± 13.2, p = .05) without relevant changes in systolic left ventricle (LV) function (p = .5). LA volumes (end‐diastolic volume [LA‐EDV] and end‐systolic volume [LA‐ESV]) (LA‐EDV: 83.1 ± 39.5 ml, 115.1 ± 55.3 ml, p = .012; LA‐ESV: 58.4 ± 33.4 ml, 80.1 ± 43.9 ml, p = .031), muscular mass (105.1 ± 49.3 g, 145.4 ± 70.6 g, p = .013), as well as LA stroke volume (24.6 ± 12.5 ml, 34.9 ± 19.1 ml, p = .016) significantly increased after the procedure. LA ejection fraction (LA‐EF: 31.7 ± 12.8%, 31.1 ± 12.3%, p = .8) and atrial global strain (aGS: −10.8 ± 5.4%, −9.7 ± 4.45%, p = .4) showed no significant changes at FU. Despite no relevant changes during FU, the baseline aGS was found to be the strongest predictor for mortality and adverse interventional outcome. Conclusion MitraClip increases atrial stroke volume, atrial volumes, and muscular mass in patients with FMR. We found that the baseline aGS the strongest predictor for mortality, rehospitalization, and higher residual MR at FU.

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Left atrial function: evaluation by strain analysis

Cited by 137 publications

References 140 publications

Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study

Predictive value of transmitral A‐wave acceleration time for paroxysmal atrial fibrillation

Left atrial global function in chronic heart failure patients with functional mitral regurgitation after MitraClip

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