Table 1. A review of existing literature on the clinical utility of LA strain mechanics.
| Clinical application | Author, publication year | Study sample size | Outcome |
|---|---|---|---|
| AF | Cameli et al., 2017 (29) | 79 | Global LASr <8.1%, predicted LAA thrombus and reduced LAA emptying velocity |
| Lacalzada-Almeida et al., 2019 (30) | 98 | SRa decrease related to evolution of new onset AF or stroke or both | |
| Yoon et al., 2015 (31) | 52 | LAS ≤30.9% was associated with AF progression | |
| Hwang et al., 2009 (32) | 40 | Average strain was associated with AF recurrence | |
| HTN | Mondillo et al., 2011 (34) | 121 | Decreases in all LAS and SR indices, exception of peak LASRa |
| Hennawy et al., 2018 (35) | 50 | Global LASr lower in the HTN despite normal LAVI | |
| Karakurt et al., 2019 (36) | 29 | Peak LAS and SR lower in HTN with preserved LAEF and LVEF | |
| HFrEF | Carluccio et al., 2018 (42) | 405 | LASr independent prognostic marker |
| Kurt et al., 2012 (43) | 62 | LAS associated with increased LVEDP | |
| Malagoli et al., 2019 (44) | 286 | Lower global LASr showed worse event-free survival | |
| HFpEF | Telles et al., 2019 (47) | 71 | Reservoir strain ≤33% associated with HFpEF hospitalization (Sen 88%, Sp 77%) |
| Freed et al., 2016 (48) | 308 | Reservoir strain correlated with composite of cardiovascular hospitalization or death | |
| Santos et al., 2016 (49) | 357 | LAS associated with HF hospitalization became non-significant after adjustment for LV systolic and diastolic function | |
| AS | Rusinaru et al., 2017 (51) | 715 | LAVI ≥45 mL/m2 lower LVEF and higher LVEDP |
| Meimoun et al., 2019 (52) | 102 | LAD ≤69% and LAS ≤17% correlated with HF and all-cause mortality | |
| CAD | Yan et al., 2012 (54) | 65 | Decreased SRe and increased SRa in CAD patients with preserved LVEF |
| Said et al., 2018 (55) | 30 | LASr and LASct lower in high syntax group | |
| Hosseinsabet et al., 2017 (56) | 205 | LAS lower in the diabetic patients than in the pre-diabetic and euglycemic patient | |
| Obesity | Oliver et al., 2017 (58) | 748 | ÄLAV correlated with BMI exclusively by associations with visceral fat mass |
| Chirinos et al., 2009 (59) | 1,531 | Obesity associated with impaired reservoir and conduit LA function and higher booster function | |
| Ischemic stroke | Sonaglioni et al., 2019 (64) | 85 | Global LASr ≤15.5% shows advanced atrial cardiomyopathy |
| Kim et al., 2016 (65) | 227 | Global LASr <14.5% better distinguished post-stroke AF than CHA2DS2-VASc score | |
| HCM | Hiemstra et al., 2017 (71) | 427 | Significantly better survival for patients with LAVI <34 mL/m2 and LASr <–15% |
| Fujimoto et al., 2018 (73) | 76 | Cardiac events more frequent with LAS <20.3% | |
| Kobayashi et al., 2017 (74) | 105 | LA function impaired in non-obstructive HCM; total and passive LA function further impaired in obstructive HCM | |
| AL | Mohty et al., 2011 (79) | 134 | LAE associated with worse overall mortality at 5 years |
| Mohty et al., 2018 (80) | 77 | Two-year survival lower with LASr <14% (P=0.034) | |
| Nochioka et al., 2017 (81) | 124 | All LA function phases significantly impaired in CA | |
| MR | Yang et al., 2015 (86) | 104 | Reduced LASp and LASRr associated with worse prognosis asymptomatic severe primary MR |
| Yang et al., 2017 (87) | 159 | Lower LASRr at baseline showed higher risk of deterioration in severe chronic Carpentier II MR | |
| DM | Kadappu et al., 2012 (92) | 73 | LAVI was larger (38.2±9.9) in DM group |
| Tadic et al., 2017 (94) | 55 | LA reservoir and conduit function significantly lower in diabetic subjects and LA booster pump function is compensatory increased |
LA, left atrial; HF, heart failure; AF, atrial fibrillation; LASr, LA reservoir strain; LAA, LA appendage; SRa, strain rate during late filling; LAS, LA strain; SR, strain rate; HTN, hypertension; LAVI, LA volume index; LAEF, LA ejection fraction; LVEF, left ventricular ejection fraction; HFrEF, HF with reduced ejection fraction; LVEDP, left ventricular end diastolic pressure; HFpEF, HF with preserved ejection fraction; Sen, sensitivity; Sp, specificity; AS, aortic stenosis; LAD, left anterior descending; CAD, coronary artery disease; SRe, strain rate during early filling; LAV, LA volume; BMI, body mass index; HCM, hypertrophic cardiomyopathy; AL, amyloidosis; LAE, LA enlargement; CA, cardiac amyloidosis; MR, mitral regurgitation; LASp, peak LA strain; LASRr, strain rate in LA filling phase; DM, diabetes mellitus.