Left Atrial Strain for Assessment of Left Ventricular Diastolic Function: Focus on Populations With Normal LVEF

Sherif F. Nagueh, Safi U. Khan

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations

Abstract

Left atrial (LA) strain has emerged as a useful parameter for the assessment of left ventricular (LV) diastolic function and the estimation of LV filling pressures. Some have advocated using LA strain by itself, mainly reservoir strain, as a single stand-alone measurement for this objective. Recent data indicate several challenges for this application in patients with normal left ventricular ejection fraction (LVEF) because of the wide range for normal values and the load dependency of LA strain. Both findings can result in reduced left atrial reservoir strain (LARS) values in normal subjects that overlap those seen in patients with diastolic dysfunction. LARS for the estimation of LV filling pressures is most accurate in patients with depressed LVEF. It is less accurate in patients with normal ejection fraction. In this group of patients, LARS <18% has high specificity for increased LV filling pressures. There are promising data showing the association of LARS with outcome events in patients with normal ejection fraction, and additional data are needed to confirm that it provides incremental information over clinical and other echocardiographic measurements.

Original languageEnglish (US)
Pages (from-to)691-707
Number of pages17
JournalJACC: Cardiovascular Imaging
Volume16
Issue number5
DOIs
StatePublished - May 2023

Keywords

  • diastole
  • echocardiography
  • left atrium
  • reservoir
  • strain
  • Stroke Volume
  • Predictive Value of Tests
  • Ventricular Dysfunction, Left
  • Ventricular Function, Left
  • Humans
  • Atrial Fibrillation/complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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