Left atrial strain: measurement and clinical application

Abstract

Purpose of review: To summarize recent literature on the use of left atrial strain in the diagnosis and management of patients with heart failure.

Recent findings: Left atrial dysfunction is a hallmark of diastolic dysfunction and heart failure, in particular, heart failure with preserved ejection fraction (HFpEF). Recently, myocardial deformation analysis via strain and strain rate measurements have been applied to the left atrium. These measurements have been shown to aid in the diagnosis of heart failure and be accurate predictors of cardiac pressures, diastolic dysfunction, exercise performance, and clinical outcomes such as cardiac hospitalizations and mortality. However, limitations related to the technical aspect of accurately imaging and tracking the thin-walled left atrium and the current lack of consensus on 'normal' reference values remain.

Summary: Left atrial strain represents a novel, noninvasive technique to aid in the diagnosis, prognosis, and management of patients with heart failure. Although it is not yet a part of routine clinical practice, the measurement has significant promise within this population pending further validation.