Left atrial strain evaluation to assess left ventricle diastolic dysfunction and heart failure with preserved ejection fraction: a guide to clinical practice : Left atrial strain and diastolic function

Int J Cardiovasc Imaging. 2023 Jun;39(6):1083-1096. doi: 10.1007/s10554-023-02816-y. Epub 2023 Feb 24.

Abstract

Although frequently unrecognized, left atrium (LA) function plays a key role in global cardiac performance as it modulates left ventricle (LV) filling through three main functions: the LA reservoir, conduit and booster pump. Given the interdependence between the LA and the LV, it is known that LA dimension and/or LA function can be used as a surrogate for LV diastolic function.Recently, LA deformation analysis using 2-dimensional (2D) speckle tracking echocardiography (STE) strain emerged as a promising non-invasive technique that can help to estimate LV filling pressures (LVFP) and diagnose heart failure with preserved ejection fraction (HFpEF), as recently proposed in the recent 2022 European Association of Cardiovascular Imaging (EACVI) consensus which included LA reservoir strain as an additive parameter to estimate LVFP.This article aims to review the latest evidence regarding the role of LA strain in the assessment and management of LV diastolic dysfunction (LVDD) and HFpEF, providing a clinical guide with tips and tricks to use LA strain as a new technique to help to estimate LVFP.

Keywords: Diastolic dysfunction; Diastolic function; HFpEF; Left atrial strain; Left atrium; Speckle tracking echocardiography.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation*
  • Heart Atria
  • Heart Failure* / diagnostic imaging
  • Heart Ventricles
  • Humans
  • Predictive Value of Tests
  • Stroke Volume
  • Ventricular Dysfunction, Left* / diagnostic imaging
  • Ventricular Function, Left