Clinical implications of left atrial function assessed by speckle tracking echocardiography

Left atrial (LA) function has a significant impact on cardiovascular diseases and has been assessed by several noninvasive methods. However, several limitations, including the dependence of image quality, single plane assessment, and time-consuming procedures, have prevented widespread clinical application of the assessment of LA function. Strain imaging using tissue Doppler echocardiography enables quantification of LA function. Recently, two-dimensional speckle tracking echocardiography (2D-STE) has been developed as a noninvasive, simple, and reproducible tool for assessment of LA function in patients with cardiovascular disease. 2D-STE enables detection of early LA dysfunction even before LA morphological changes. LA dysfunction determined by 2D-STE can provide additional prognostic information to conventional echocardiographic parameters in patients with cardiovascular diseases. Hence, 2D-STE appears to be a promising technique for diagnosis and therapeutic decision-making. However, standardization of analysis techniques and software applications of 2D-STE is still lacking. Here, we review recent studies on clinical implications of LA function assessed by 2D-STE and summarize the remaining problems to be solved to improve the clinical utility of this tool.