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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Left atrial strain in left ventricular diastolic dysfunction: have we finally found the missing piece of the puzzle?

Giulia Elena Mandoli1, Nicolò Sisti2, Sergio Mondillo1

  • 1Department of Cardiovascular Diseases, University of Siena, Siena, Italy.

Heart Failure Reviews
|November 28, 2019
PubMed

Insights

Left atrial longitudinal strain measured by speckle tracking echocardiography offers a sensitive method to assess diastolic dysfunction and guide heart failure management. This technique improves upon traditional echocardiography, especially for heart failure with preserved ejection fraction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Echocardiography is crucial for evaluating diastolic function and left ventricular filling pressures in heart failure (HF) patients.
  • Current algorithms for diastolic dysfunction (DD) grading have limitations, including a "gray zone".
  • The rising incidence of heart failure with preserved ejection fraction (HFpEF) necessitates more sensitive diagnostic tools.

Purpose of the Study:

  • To review the evidence for left atrial (LA) longitudinal strain using speckle tracking echocardiography (STE).
  • To explore LA strain's role in assessing diastolic function and HFpEF.
  • To evaluate LA strain as a diagnostic and therapeutic management parameter.

Main Methods:

  • Utilizing speckle tracking echocardiography (STE) to measure left atrial (LA) longitudinal strain.
  • Analyzing LA strain's angle-independent and reproducible measurement capabilities.
  • Reviewing current literature on LA strain in diastolic dysfunction and HFpEF assessment.

Main Results:

  • Left atrial (LA) longitudinal strain demonstrates high specificity and sensitivity for diastolic dysfunction (DD) assessment.
  • LA strain overcomes limitations of Doppler-based echocardiography.
  • LA strain provides reproducible measures of left atrial (LA) deformation, crucial for left ventricular (LV) function.

Conclusions:

  • Left atrial (LA) longitudinal strain is a valuable parameter for evaluating diastolic function and guiding HFpEF management.
  • LA strain can be used within standard echocardiographic algorithms or as a standalone diagnostic tool.
  • This technique enhances the noninvasive assessment of diastolic function, improving patient care.

Keywords:
Diastolic functionHFpEFLeft atrial strainLeft atriumSpeckle tracking echocardiography

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