Normal reference values of right atrial strain parameters using three-dimensional speckle-tracking echocardiography (results from the MAGYAR-Healthy Study)

Abstract

Classic echocardiographic methodologies offer limited opportunities in assessing right atrial (RA) morphology and function. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is a novel imaging method with objective 3D capability in assessing volumetric and functional properties of heart chambers. Normal reference values of different 3DSTEderived RA strains are not available, therefore the aim of this prospective study was to establish these parameters in healthy subjects. The present study comprised 295 healthy volunteers, from which 110 were excluded due to inadequate image quality. The final population consisted of 185 healthy subjects in the present study (mean age: 32.1 ± 12.2 years, 89 males). Complete two-dimensional echocardiography and 3DSTE have been performed in all cases. While radial strain (RS) does not change significantly over the years in males, in female subjects it increases with age most significantly between at the age of 40-49, and it starts to decline at the age of 50 in females. While females have higher circumferential (CS) and area (AS) strain values, CS and AS decrease with age in both gender. While LS remains almost unchanged in females until ages 40-49 years with a decline above the age of 50, it decreases over the decades in males. 3D strain (3DS) increases with age in both gender, but almost doubles in females in older ages. Specific pattern of strains at atrial contraction could also be demonstrated. 3DSTE-derived RA normal reference values with age-, gender-dependency and regional values are demonstrated in a healthy population.

Normal reference values of three‐dimensional speckle‐tracking echocardiography‐derived mitral annular dimensions and functional properties in healthy adults: Insights from the MAGYAR‐Healthy Study

“…Moreover, the results can only be applied to the Toshiba equipment we used. As mentioned above, only 2D MA projection was evaluated during 3DSTE analysis, not its real 3D saddle shape 10 The present study did not aim to compare 2D‐ and 3DSTE‐derived MA dimensions. We included a limited number of cases older than 50 years, and none over 60 years. Although 3DSTE could combine volumetric and strain assessments allowing more detailed analysis from the same 3D echocardiographic dataset 3‐8 for MA featuring, no volumes or strains of other heart chambers were assessed in the present study. …”

“…• Although 3DSTE could combine volumetric and strain assessments allowing more detailed analysis from the same 3D echocardiographic dataset [3][4][5][6][7][8] for MA featuring, no volumes or strains of other heart chambers were assessed in the present study.…”

“…along the cardiac cycle. 1,2 More and more 3DSTE-based clinical data are available in different pathological conditions together with normal reference values of left ventricular (LV), [3][4][5] left atrial (LA), 6 and right atrial (RA) 7,8 volumes/volume-based functional properties, 8 strains, 3,4,6,7 and rotational variables 5 in healthy adults, as well as their vendor-dependency. 9 Moreover, the clinical usefulness of 3DSTE in the assessment of mitral annular dimensions and its close relationship to LV function was also confirmed.…”

Normal reference values of left ventricular strain parameters in healthy adults: Real‐life experience from the single‐center three‐dimensional speckle‐tracking echocardiographic MAGYAR‐Healthy Study

“…3D STE (3DSTE) incorporates advantages of both 3D and STE methodologies: it is able to simultaneously assess volumes and functional (strain) variables from the same 3D dataset 1‐6 . A number of studies defining normal values of 3DSTE‐derived parameters is presently available, including left ventricular (LV), 9‐14 left atrial, 15 and right atrial 16,17 volumetric, 17 strain, 10–12,14 and rotational data 9,10,13 . The present prospective study aimed to quantify normal reference values of LV strains in healthy adult population in real clinical world settings in different age groups and to determine age‐ and gender‐dependence of these variables in a high volume single center.…”

Right Atrial Strain as a Surrogate Marker for Right Ventricular Function in Patients with Heart Failure

“… 15) There has been growing interest in markers of RA myocardial dysfunction using 2D speckle-tracking echocardiography (STE) and even further with 3D STE. 16) 17) Of course, the RA strain value is not a parameter that can replace right heart catheterization (RHC) in cases of critically ill patients before a heart transplant. Thanks to this study, however, I think that the RA strain value might be a good parameter for RV diastolic function because the RA strain value has a stronger background (in that it can be used as a reference value for patient treatment before RV failure has already progressed or when RHC could be not performed).…”