Methodological Gaps in Left Atrial Function Assessment by 2D Speckle Tracking Echocardiography

Abstract

The assessment of left atrial (LA) function is used in various cardiovascular diseases. LA plays a complementary role in cardiac performance by modulating left ventricular (LV) function. Transthoracic two-dimensional (2D) phasic volumes and Doppler echocardiography can measure LA function non-invasively. However, evaluation of LA deformation derived from 2D speckle tracking echocardiography (STE) is a new feasible and promising approach for assessment of LA mechanics. These parameters are able to detect subclinical LA dysfunction in different pathological condition. Normal ranges for LA deformation and cut-off values to diagnose LA dysfunction with different diseases have been reported, but data are still conflicting, probably because of some methodological and technical issues. This review highlights the importance of an unique standardized technique to assess the LA phasic functions by STE, and discusses recent studies on the most important clinical applications of this technique.

Left atrial function in children and young adult cancer survivors treated with anthracyclines

“…GLS measurements frequently differ depending on the specific echocardiographic views, and the global GLS typically benefits from analysis of the 2-chamber, 3-chamber, and 4-chamber views. 21 Our study has several limitations. The sample size was modest, and there was heterogeneity in regards to total cumulative anthracycline dose and radiation exposure.…”

“…Typically, 2D global GLS reflects the average GLS from the 4‐chamber, 3‐chamber, and 2‐chamber view. GLS measurements frequently differ depending on the specific echocardiographic views, and the global GLS typically benefits from analysis of the 2‐chamber, 3‐chamber, and 4‐chamber views …”

“…Image resolution was optimized for best image quality. The apical 4‐chamber view was used in order to maximize LA visibility and to minimize inter‐study variability in strain values …”

Assessment of left atrial function in feline hypertrophic cardiomyopathy by using two- dimensional speckle tracking echocardiography

“…The present study showed that the LA roof had the lowest longitudinal strain. The LA roof is closed to the mediastinum, which may limit the movement of this region [26]. In humans, the strains of base and mid regions are similar [40].…”

Effects of vitamin D deficiency on left atrial function as evaluated by 2D speckle‐tracking echocardiography

“…We set zero level in 2DSTE analysis at the R wave time, but this is not a perfectly realistic method since it is not consistent with normal LA physiology as the produced strain curve did not show a negative peak during LA myocardial contraction. 36 As the initial length is determinant in the calculation of strain, using the R wave as the zero level results in some parts of the LA myocardial walls being in contraction while some others are in relaxation. Setting the zero at the beginning of the P wave would overcome this limitation, as evidenced by the agreement between the results of 3DSTE and 2DSTE as regards the evaluation of LA strain.…”