Right Atrial Speckle Tracking Strain Echocardiography in HeartFailure

Abstract

Background Speckle tracking echocardiography (STE) has emerged as a useful tool in diagnostic and prognostic cardiology, especially for pathologies such as heart failure (HF). This review represents a comprehensive review of contemporary data available on right atrial (RA) STE studies for various cardiac pathologies in the form of a meta-analysis and literature review. Methods The authors searched the PubMed databases for the key terms related to ‘‘Right atrial/ atrial/atrium’’ and ‘‘strain/function/deformation/stiffness’’ and ‘‘speckle tracking imaging.’’ Studies of global RA function using speckle-tracking were selected if they involved >25 participants. The search was completed on January 25, 2018. Abstract posters were excluded because of inadequate baseline characteristics or methodology. Results Our searches returned 463 studies. Fifty-nine studies met criteria, eight were excluded. Our review did not show a significant difference between R-R (62%) and P-P (38%) gating with regard to the practice of measurement of RA strain. Most studies were focused on the pulmonary hypertension (PH) (35%) and heart failure (HF) (30%). The remainder (35%) were studies of other cardiac diseases. Almost (80%) were retrospective single studies, and (37%) had control groups. Our subgroup analysis compared vendors General Electric (GE) (58%) vs non-GE (42%), because vendor differences are based primarily on algorithms used to compute strain. We found no significant difference between vendors. Conclusion Studies evaluating RA STE diagnostic and prognostic importance are minimal, however STE studies presented added a prognostic value to the traditional echocardiographic parameters. There are no reference values for RA strain measurements in the guidelines. Additional prospective and randomized controlled trials are needed to establish right atrial STE as a standardized approach to patient care.