Table 2.

Main limitations of strain analysis in LV, RV and LA function.

LV-GLS	LA Strain
Geometric assumption Angle dependent Acoustic window Manual adjustments Large-scale studies are needed to validate the findings in order to have an accepted standard validation Inappropriate measuresdue to imprecise customization or inaccurate ROI	Lack of universally accepted standard validation Preload dependent Manual adjustments Relatively small prevalence of LA strain dysfunction in patients suffering from HFpEF with high LA pressure. Large-scale studies are needed to validate the findings in order to have an accepted standard validation

GLS indicates Global Longitudinal Strain; HFpEF, heart failure with preserved ejection fraction; LA, left atrial; LV, left ventricle; ROI, region of interest.