J Cardiovasc Imaging.  2020 Jul;28(3):186-198. 10.4250/jcvi.2020.0043.

Normal Reference Values for Left Atrial Strain and Its Determinants from a Large Korean Multicenter Registry

• Sun BJ
• Park JH
• Lee M
• Choi JO
• Lee JH
• Shin MS
• Kim MJ
• Jung HO
• Park JR
• Sohn IS
• Kim H
• Kim HK
• Cho GY
• Park JS
• Shim CY
• Shin SH
• Kim KH
• Kim WS
• Park SW

• KMID: 2503283
• DOI: http://doi.org/10.4250/jcvi.2020.0043

Abstract

BACKGROUND
Left atrial (LA) strain is a novel parameter of LA function. However, its reference value has not been established, and the determining factors for LA strain remain elusive. We aimed to present LA strain with reservoir, conduit, and contractile components and associated parameters in a large-sized group of healthy individuals.
METHODS
The present study was from a prospective multicenter registry in South Korea. Subjects who had no history of cardiovascular disease with adequate images were eligible for inclusion. LA reservoir, conduit, and contractile strains (LASRES, LASCD and LASCT, respectively) were measured. Left ventricular global longitudinal strain (LV GLS) and early and late diastolic strain rates (DSRe and DSRa, respectively) were also evaluated.
RESULTS
Among a total of 324 subjects (mean age: 49 ± 16 years, 167 females), the mean LASRES, LASCD, and LASCT values were 35.9% ± 10.6%, 21.9% ± 9.3%, and 13.9% ± 3.6%, respectively. Mean LV GLS was -20.4% ± 2.2%, and mean DSRe and DSRa were 1.6 ± 0.4 s-1 and 0.8 ± 0.3 s-1, respectively. With aging, LASRES and LASCD showed significant decreases. Factors showing independent associations with LASRES were age (B = -0.425, p < 0.001), DSRe (B = 4.706, p = 0.001), and LV GLS (B = -1.081, p < 0.001). Age (B = -0.319, p < 0.001), DSRe (B = 4.140, p = 0.002), DSRa (B = -3.409, p = 0.018), and LV GLS (B = -0.783, p < 0.001) showed associations with LASCD. With LASCT, only DSRa showed a correlation (R = 0.277, p < 0.001).
CONCLUSIONS
We presented LA strain in a large-sized group of healthy subjects. Age is a significant determinant of LA function. Associations of LA strain with diastolic strain rates and LV GLS reflect cardiac mechanics.

Keyword

LA function; LA strain; Speckle-tracking echocardiography