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Left Atrial Strain Correlation with Functional Capacity and Additional Prognostic Value of Speckle Tracking in

Maria Concetta Pastore1, Marta Focardi1, Federica Marrese1

  • 1Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy.

Journal of Clinical Medicine
|February 27, 2026
PubMed

Insights

Left atrial strain (LA strain) measured by speckle tracking echocardiography (STE) correlates with functional capacity and congestion in cardiac amyloidosis (CA). LA strain parameters offer improved prognostic value for predicting adverse outcomes in CA patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Cardiac amyloidosis (CA) is characterized by diastolic dysfunction, reduced functional capacity, and poor prognosis.
  • Left atrial (LA) strain, assessed via speckle tracking echocardiography (STE), reflects diastolic function and heart failure symptoms.

Purpose of the Study:

  • To investigate the association between LA strain and functional capacity in CA patients.
  • To determine the prognostic significance of STE-derived variables in CA.

Main Methods:

  • Prospective enrollment of 75 consecutive CA outpatients.
  • Clinical assessment, echocardiography, 6-minute walking test (6MWT), and Kansas City Cardiomyopathy Questionnaire (KCCQ) were performed.
  • Primary endpoint: correlation of global peak atrial longitudinal strain (PALS) with NTproBNP, 6MWT, and KCCQ. Secondary endpoint: prediction of death or HF hospitalization.

Main Results:

  • Global PALS correlated significantly with NTproBNP and 6MWT, but not KCCQ.
  • Global longitudinal strain (GLS) correlated with NTproBNP.
  • Global PALS < 13.5% and GLS > -12% predicted the combined endpoint (death/HF hospitalization) with high accuracy (AUC 0.72-0.73), outperforming NTproBNP.

Conclusions:

  • Global PALS is linked to congestion and functional capacity, serving as an objective marker of CA severity.
  • STE parameters, including PALS and GLS, can enhance prognostic stratification in cardiac amyloidosis.

Keywords:
cardiac amyloidosisechocardiographyfunctional capacityprognosisspeckle tracking

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