Abstract
Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.
Highlights
The left atrium modulates left ventricular filling and cardiac performance through its roles as a reservoir [1,2,3], conduit [4], and booster pump [5]
Left atrial (LA) function has 3 phases: reservoir, conduit, and contraction [2]
This paper described a specific time schedule of atrial contraction
Summary
The left atrium modulates left ventricular filling and cardiac performance through its roles as a reservoir [1,2,3], conduit [4], and booster pump [5]. The atrial booster pump function is lost due to asynchronous atrial contractions during AF. This loss is associated with a fall in cardiac output, which has particular relevance in ventricular hypertrophy and ischemic heart disease, in which diastolic performance is already abnormal [19]. Standard evaluations of diastolic function using pulsedwave (PW) Doppler of mitral inflow and tissue Doppler imaging (TDI) supplemented with LA deformation studies can diagnose early LA disease processes, thereby guiding treatments to prevent the development or recurrence of AF. Strain and strain-rate imaging to assess LA function in hypertensive patients with normal LA size demonstrated a lower reservoir function in each LA segment that was independent of age, sex, and heart rate [20].
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