Left Atrial Strain Measured by Two-Dimensional Speckle Tracking Represents a New Tool to Evaluate Left Atrial Function

Roberto M. Saraiva, Sayit Demirkol, Adisai Buakhamsri, Neil Greenberg, Zoran B. Popović, James D. Thomas, Allan L. Klein*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

274 Scopus citations


Background: Left atrial (LA) strain (ε{lunate}) and ε{lunate} rate (SR) analysis by two-dimensional speckle tracking can represent a new tool to evaluate LA function. To assess its potential value, the authors addressed whether LA ε{lunate} and SR measured in normal subjects correlates with other Doppler echocardiographic parameters that evaluate LA function and left ventricular function. Methods: Sixty-four healthy subjects were studied. LA ε{lunate} and SR were calculated with the reference point set at the P wave, which enabled the recognition of peak negative ε{lunate} (ε{lunate}neg peak), peak positive ε{lunate} (ε{lunate}pos peak), and the sum of those values, total LA ε{lunate} (ε{lunate}tot), corresponding to LA contractile, conduit, and reservoir function, respectively. Similarly, peak negative SR (LA SRlate neg peak) during LA contraction, peak positive SR (LA SRpos peak) at the beginning of LV systole, and peak negative SR (LA SRearly neg peak) at the beginning of LV diastole were identified. Results: Global LA ε{lunate}pos peak, ε{lunate}neg peak, and ε{lunate}tot were 23.2 ± 6.7%, -14.6 ± 3.5%, and 37.9 ± 7.6%, respectively. Global LA SRpos peak, SRearly neg peak, and SRlate neg peak were 2.0 ± 0.6 s-1, -2.0 ± 0.6 s-1, and -2.3 ± 0.5 s-1, respectively. The above-described variables derived from analysis of global LA ε{lunate} and LA SR correlated significantly with Doppler echocardiographic indexes that evaluated the same phase of the cardiac cycle or the same component of the LA function, including indexes derived from mitral inflow, pulmonary vein velocities, tissue Doppler, and LA volumes. Global LA ε{lunate}pos peak, LA ε{lunate}tot, and LA SRearly neg peak also correlated significantly with age or body mass index. Global LA SRlate neg peak also correlated significantly with age. Conclusions: LA ε{lunate} analysis is a new tool that can be used to evaluate LA function. Further studies are warranted to determine the utility of LA ε{lunate} in disease states.

Original languageEnglish (US)
Pages (from-to)172-180
Number of pages9
JournalJournal of the American Society of Echocardiography
Issue number2
StatePublished - Feb 2010


  • Left atrial function
  • Reference values
  • Two-dimensional strain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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