Strain and strain rate imaging in evaluating left atrial appendage function by transesophageal echocardiography

Echocardiography. 2007 Sep;24(8):823-9. doi: 10.1111/j.1540-8175.2007.00469.x.

Abstract

Background: This study was planned to assess whether strain rate (Sr) and strain (S) echocardiography is a useful method for functional assessment of the left atrial appendage (LAA).

Material and methods: Fifty-seven consecutive patients underwent a clinically indicated study. LAA late empty velocity (LAAEV) was calculated as a gold standard for left atrial appendage function. Real-time 2-dimensional color Doppler myocardial imaging data were recorded from the LAA at a high frame rate. Analysis was performed for LAA longitudinal strain rate and strain from midsegment of lateral wall of LAA. LAA strain determines regional lengthening expressed as a positive value or shortening expressed as a negative value. Peak systolic values were calculated from the extracted curve.

Results: Spearman correlation test results showed a statistically significant positive correlation was between the S, Sr variables and LAAEV (LAAEV vs S; r = 0.886, P < 0.001; LAAEV vs Sr: r = 0.897, P < 0.001, respectively). Strain and strain rate values were also significantly lower in patients with spontaneous echocardiographic contrast when compared with those without (strain; 2.42 +/- 0.98 vs 13.1 +/- 5.9, P < 0.001 and strain rate: 0.97 +/- 0.54 vs 3.34 +/- 1.15, P < 0.001, respectively). In addition, LAA strain and strain rate values were significantly lower in the patients with LAA thrombus (strain; 2.15 +/- 0.96 vs 8.35 +/- 6.9, P < 0.001, strain rate; 0.79 +/- 0.46 vs 2.30 +/- 1.48, P < 0.001, respectively).

Conclusion: S and Sr imaging can be considered a robust technique for the assessment of the LAA systolic deformation.

MeSH terms

  • Atrial Appendage / diagnostic imaging
  • Atrial Appendage / physiopathology*
  • Atrial Function, Left / physiology*
  • Coronary Thrombosis / diagnostic imaging*
  • Coronary Thrombosis / etiology
  • Coronary Thrombosis / physiopathology
  • Echocardiography, Transesophageal*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Systole