Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Cardiovascular Ultrasound
Published in: Cardiovascular Ultrasound 1/2012

Open Access 01-02-2012 | Review

Novel echocardiographic techniques to assess left atrial size, anatomy and function

Authors: Matteo Cameli, Matteo Lisi, Francesca Maria Righini, Sergio Mondillo

Published in: Cardiovascular Ultrasound | Issue 1/2012

Login to get access

Abstract

Three-dimensional echocardiography (3DE) and speckle tracking echocardiography (STE) have recently applied as imaging techniques to accurately evaluate left atrial (LA) size, anatomy and function. 3DE and off-line quantification softwares, have allowed, in comparison to magnetic resonance imaging, the most time-efficient and accurate method of LA volume quantification. STE provides a non-Doppler, angle-independent and objective quantification of LA myocardial deformation. Data regarding feasibility, accuracy and clinical applications of LA analysis by 3DE and STE are rapidly gathering. This review describes the fundamental concepts of LA 3DE and STE, illustrates how to obtain respective measurements and discuss their recognized and emerging clinical applications.
Appendix
Available only for authorised users
Literature
1.
Phang RS, Isserman SM, Karia D, Pandian NG, Homoud MS, Link MS, Estes NA, Wang PJ: Echocardiographic evidence of left atrial abnormality in young patients with lone paroxysmal atrial fibrillation. Am J Cardiol. 2004, 94: 511-3. 10.1016/j.amjcard.2004.05.009CrossRefPubMed
2.
Moller JE, Hillis GS, Oh JK, Seward JB, Reeder GS, Wright RS, Park SW, Bailey KR, Pellikka PA: Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003, 107: 2207-12. 10.1161/01.CIR.0000066318.21784.43CrossRefPubMed
3.
Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB: Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002, 90: 1284-9. 10.1016/S0002-9149(02)02864-3CrossRefPubMed
4.
Mondillo S, Galderisi M, Mele D, Cameli M, Lomoriello VS, Zacà V, Ballo P, D'Andrea A, Muraru D, Losi M, Agricola E, D'Errico A, Buralli S, Sciomer S, Nistri S, Badano L: Echocardiography Study Group Of The Italian Society Of Cardiology (Rome, Italy). Speckle-tracking echocardiography: a new technique for assessing myocardial function. J Ultrasound Med. 2011, 30 (1): 71-83.PubMed
5.
Tsang TS, Barnes ME, Bailey KR, Leibson CL, Montgomery SC, Takemoto Y, Diamond PM, Marra MA, Gersh BJ, Wiebers DO, Petty GW, Seward JB: Left atrial volume: important risk marker of incident aial fibrillation in 1655 older men and women. Mayo Clin Proc. 2001, 76: 467-75. 10.4065/76.5.467CrossRefPubMed
6.
Barnes ME, Miyasaka Y, Seward JB, Gersh BJ, Rosales AG, Bailey KR, Petty GW, Wiebers DO, Tsang TS: Left atrial volume in the prediction of first ischemic stroke in an elderly cohort without atrial fibrillation. Mayo Clin Proc. 2004, 79: 1008-14. 10.4065/79.8.1008CrossRefPubMed
7.
Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, Cha SS, Seward JB: Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter?. J Am Coll Cardiol. 2006, 47: 1018-23. 10.1016/j.jacc.2005.08.077CrossRefPubMed
8.
Lang RM, Bierig M, Devereux RB, Lang RM, Flachskampf FA, Foster E, Pellika PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W: Recommendations for chamber quantification. Eur J Echocardiography. 2006, 7: 79-108. 10.1016/j.euje.2005.12.014.CrossRef
9.
Anwar AM, Soliman OI, Geleijnse ML, Nemes A, Vletter WB, tenCate FJ: Assessment of left atrial volume and function by real-time three-dimensional echocardiography. Int J Cardiol. 2008, 123: 155-61. 10.1016/j.ijcard.2006.12.017CrossRefPubMed
10.
Miyasaka Y, Tsujimoto S, Maeba H, Yuasa F, Takehana K, Dote K, Iwasaka T: Left atrial volume by three-dimensional echocardiography: validation by 64-slice multidetector computed tomography. J Am Soc Echocardiogr. 2011, 24: 680-6. 10.1016/j.echo.2011.03.009CrossRefPubMed
11.
Aune E, Baekkevar M, Roislien J, Rodevand O, Otterstad JE: Normal reference range for left and right atrial volume indexes and ejection fractions obtained with real-time three-dimensional echocardiography. Eur J Echocardiogr. 2009, 10: 738-44. 10.1093/ejechocard/jep054CrossRefPubMed
12.
Rodevan O, Bjornerheim R, Ljosland M, Maehle J, Smith HJ, Ihlen H: Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates. Int J Card Imaging. 1999, 15: 397-410. 10.1023/A:1006276513186CrossRefPubMed
13.
Artang R, Migrino RQ, Harmann L, Bowers M, Woods TD: Left atrial volume measurement with automated border detection by 3-dimensional echocardiography: comparison with magnetic resonance imaging. Cardiovasc Ultrasound. 2009, 7: 16-24. 10.1186/1476-7120-7-16CrossRefPubMedPubMedCentral
14.
Keller AM, Gopal AS, King DL: Left and right atrial volume by freehand three-dimensional echocardiography: in vivo validation using magnetic resonance imaging. Eur J Echocardiogr. 2000, 1: 55-65. 10.1053/euje.2000.0010CrossRefPubMed
15.
Khankirawatana B, Khankirawatana S, Lof J, Porter TR: Left atrial volume determination by three-dimensional echocardiography reconstruction: validation and application of a simplied technique. J Am Soc Echocardiogr. 2002, 15: 1051-6. 10.1067/mje.2002.122080CrossRefPubMed
16.
Murata M, Iwanaga S, Tamura Y, Kondo M, Kouyama K, Murata M, Ogawa S: Real-time three-dimensional echocardiographic quantitative analysis of left ventricular diastolic dysfunction. Am J Cardiol. 2008, 8: 1097-102.CrossRef
17.
Maddukuri PV, Vieira MCL, De castro S, Maron MS, Kuvin JT, Patel AR, Pandian NG: What is the best approach for the assessment of left atrial size? Comparison of various unidimensional and two-dimensional parameters with three-dimensional echocardiographically determined left atrial volume. J Am Soc Echocardiogr. 2006, 19: 1026-32. 10.1016/j.echo.2006.03.011CrossRefPubMed
18.
Jenkins C, Chan J, Hanekom L, Marwick TH: Accuracy and feasibility of online 3-dimensional echocardiography for measurement of left ventricular parameters. J Am Soc Echocardiogr. 2006, 19: 1119-28. 10.1016/j.echo.2006.04.002CrossRefPubMed
19.
Hung J, Lang R, Flachskampf F, Shernan S, McCulloch ML, Adams DB, Thomas J, Vannan M, Ryan T: 3D echocardiography: a review of the current status and future directions. J Am Soc Echocardiogr. 2007, 20: 213-233. 10.1016/j.echo.2007.01.010CrossRefPubMed
20.
Abhayaratna WP, Seward J, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TSM: Left atrial size. Physiologic determinants and clinical applications. J Am Coll Cardiol. 2006, 47: 2357-63. 10.1016/j.jacc.2006.02.048CrossRefPubMed
21.
Suh IW, Song JM, Lee EY, Kang SH, Kim MJ, Kim JJ, Kang DH, Song JK: Left atrial volume measured by real-time 3 dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. J Am Soc Echocardiogr. 2008: 439-445. 10.1016/j.jacc.2006.02.048
22.
Cameli M, Caputo M, Mondillo S, Ballo P, Palmerini E, Lisi M, Marino E, Galderisi M: Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking. Cardiovascular Ultrasound. 2009, 7: 6- 10.1186/1476-7120-7-6CrossRefPubMedPubMedCentral
23.
Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP: Two-Dimensional Speckle-Tracking Echocardiography of the Left Atrium: Feasibility and Regional Contraction and Relaxation Differences in Normal Subjects. J Am Soc Echocardiogr. 2009, 22: 299-305. 10.1016/j.echo.2008.12.017CrossRefPubMed
24.
Kim DG, Lee KJ, Lee S, Jeong SY, Lee YS, Choi YJ, Yoon HS, Kim JH, Jeong KT, Park SC, Park M: Feasibility of two-dimensional global longitudinal strain and strain rate imaging for the assessment of left atrial function: a study in subjects with a low probability of cardiovascular disease and normal exercise capacity. Echocardiography. 2009, 26: 1179-87. 10.1111/j.1540-8175.2009.00955.xCrossRefPubMed
25.
Saraiva RM, Demirkol S, Buakhamsri A, Greenberg N, Popović ZB, Thomas JD, Klein AL: Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function. J Am Soc Echocardiogr. 2010, 23: 172-80. 10.1016/j.echo.2009.11.003CrossRefPubMed
26.
Sirbu C, Herbots L, D'hooge J, Claus P, Marciniak A, Langeland T, Bijnens B, Rademakers FE, Sutherland GR: Feasibility of strain and strain rate imaging for the assessment of regional left atrial deformation: a study in normal subjects. Eur J Echocardiogr. 2006, 7: 199-208. 10.1016/j.euje.2005.06.001CrossRefPubMed
27.
Okamatsu K, Takeuchi M, Nakai H, Nishikage T, Salgo IS, Husson S, Otsuji Y, Lang RM: Effects of aging on left atrial function assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr. 2009, 22: 70-75. 10.1016/j.echo.2008.11.006CrossRefPubMed
28.
D'Andrea A, Caso P, Romano S, Scarafile R, Riegler L, Salerno G, Limongelli G, Di Salvo G, Calabrò P, Del Viscovo L, Romano G, Maiello C, Santangelo L, Severino S, Cuomo S, Cotrufo M, Calabrò R: Different effects of cardiac resynchronization therapy on left atrial function in patients with either idiopathic or ischaemic dilated cardiomyopathy: a two-dimesnsional spekle strain study. Eur Heart J. 2007, 28: 2738-2748. 10.1093/eurheartj/ehm443CrossRefPubMed
29.
Di Salvo G, Pacileo G, Castaldi B, Gala S, Morelli C, D'Andrea A, Limongelli G, Del Gaizo F, Merlino E, Russo MG, Calabrò R: Two-dimensional strain and atrial function: a study on patients after percutaneous closure of atrial septal defect. Eur J Echocardiogr. 2009, 10: 256-259.CrossRefPubMed
30.
Cameli M, Lisi M, Giacomin E, Caputo M, Navarri R, Malandrino A, Ballo P, Agricola E, Mondillo S: Chronic Mitral Regurgitation: Left Atrial Deformation Analysis by Two-Dimensional Speckle Tracking Echocardiography. Echocardiography. 2011, 28 (3): 327-34. 10.1111/j.1540-8175.2010.01329.xCrossRefPubMed
31.
Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL: Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications Endorsed by the Japanese Society of Echocardiography. Eur J Echocardiogr. 2011, 12 (3): 167-205. 10.1093/ejechocard/jer021CrossRefPubMed
32.
Barbier P, Solomon SB, Shiller NB, Glantz SA: Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation. 1999, 100: 427-436.CrossRefPubMed
33.
Melenovsky V, Borlaug BA, Rosen B, Hay I, Ferruci L, Morell CH, Lakatta EG, Najjar SS, Kass DA: Cardiovascular features of heart failure with preserved ejection fraction versus nonfailing hypertensive left ventricular hypertrophy in the urban Baltimore community: the role of atrial remodeling/dysfunction. J Am Coll Cardiol. 2007, 49: 198-207. 10.1016/j.jacc.2006.08.050CrossRefPubMed
34.
Gottdiener JS, Kitzman DW, Aurigemma GP, Arnold AM, Manolio TA: Left atrial volume, geometry, and function in systolic and diastolic heart failure of persons > or = 65 years of age (The cardiovascular health study). Am J Cardiol. 2006, 97: 83-89. 10.1016/j.amjcard.2005.07.126CrossRefPubMed
35.
Kurt M, Wang J, Torre-Amione G, Nagueh SF: Left atrial function in diastolic heart failure. Circ Cardiovasc Imaging. 2009, 2: 10-15. 10.1161/CIRCIMAGING.108.813071CrossRefPubMed
36.
Mondillo S, Cameli M, Caputo ML, Lisi M, Palmerini E, Padeletti M, Ballo P: Early Detection of Left Atrial Strain Abnormalities by Speckle-Tracking in Hypertensive and Diabetic Patients with Normal Left Atrial Size. J Am Soc Echocardiogr. 2011, 24: 898-908. 10.1016/j.echo.2011.04.014CrossRefPubMed
37.
Cameli M, Lisi M, Righini F, Ballo P, Henein M, Mondillo S: Early detection of left atrial dysfunction in patients with hypertension by two-dimensional speckle tracking echocardiography. (abstr)In: EUROECHO Congress. Copenaghen 2010. Eur J Echocardiogr, Abstracts Supplement. 2010, P802-
38.
D'Ascenzi F, Cameli M, Zacà V, Lisi M, Santoro A, Causarano A, Mondillo S: Supernormal diastolic function and role of left atrial myocardial deformation analysis by 2D speckle tracking echocardiography in elite soccer players. Echocardiography. 2011, 28 (3): 320-6. 10.1111/j.1540-8175.2010.01338.xCrossRefPubMed
39.
Mullens W, Borowski A, Curtin R, Thomas J, Tang W: Tissue Doppler imaging in the estimation of intracrdiac filling pressure in decompensated patients with advanced systolic heart failure. Circulation. 2009, 119: 62-70. 10.1161/CIRCULATIONAHA.108.779223CrossRefPubMed
40.
Wakami K, Ohte N, Asada K, Fukuta H, Goto T, Mukai S, Narita H, Kimura G: Correlation between left ventricular end-diastolic pressure and peak left atrial wall strain during left ventricular systole. J Am Soc Echocardiogr. 2009, 22: 847-851. 10.1016/j.echo.2009.04.026CrossRefPubMed
41.
Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, Bernazzali S, Maccherini M: Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010, 8: 14- 10.1186/1476-7120-8-14CrossRefPubMedPubMedCentral
42.
Shih JY, Tsai WC, Huang YY, Liu YW, Lin CC, Huang YS, Tsai LM, Lin LJ: Association of decreased left atrial strain and strain rate with stroke in chronic atrial fibrillation. J Am Soc Echocardiogr. 2011, 24 (5): 513-9. 10.1016/j.echo.2011.01.016CrossRefPubMed
43.
Saha SK, Anderson PL, Caracciolo G, Kiotsekoglou A, Wilansky S, Govind S, Mori N, Sengupta PP: Global Left Atrial Strain Correlates with CHADS(2) Risk Score in Patients with Atrial Fibrillation. J Am Soc Echocardiogr. 2011, 24 (5): 506-12. 10.1016/j.echo.2011.02.012CrossRefPubMed
44.
Donal E, Ollivier R, Veillard D, Hamonic S, Pavin D, Daubert JC, Mabo P: Left atrial function assessed by trans-thoracic echocardiography in patients treated by ablation for a lone paroxysmal atrial fibrillation. Eur J Echocardiogr. 2010, 11: 845-52. 10.1093/ejechocard/jeq074CrossRefPubMed
45.
Inaba Y, Yuda S, Kobayashi N, Hashimoto A, Uno K, Nakata T, Tsuchihashi K, Miura T, Ura N, Shimamoto K: Strain rate imaging for noninvasive functional quantification of the left atrium: comparative studies in controls and patients with atrial fibrillation. J Am Soc Echocardiogr. 2005, 18: 729-736. 10.1016/j.echo.2004.12.005CrossRefPubMed
46.
Schneider C, Malisius R, Krause K, Lampe F, Bahlmann E, Boczor S, Antz M, Ernst S, Kuck KH: Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. European Heart Journal. 2008, 29: 1397-1409. 10.1093/eurheartj/ehn168CrossRefPubMed
47.
Kuppahally SS, Akoum N, Burgon NS, Badger TJ, Kholmovski EG, Vijayakumar S, Rao SN, Blauer J, Fish EN, Dibella EV, Macleod RS, McGann C, Litwin SE, Marrouche NF: Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI. Circ Cardiovasc Imaging. 2010, 3 (3): 231-9. 10.1161/CIRCIMAGING.109.865683CrossRefPubMed
48.
Tsai WC, Lee CH, Lin CC, Liu YW, Huang YY, Li WT, Chen JY, Lin LJ: Association of left atrial strain and strain rate assessed by speckle tracking echocardiography with paroxysmal atrial fibrillation. Echocardiography. 2009, 26: 10- 10.1111/j.1540-8175.2008.00753.xCrossRef
49.
Cameli M, Lisi M, Righini FM, Focardi M, Alfieri O, Mondillo S: Left atrial speckle tracking analysis in patients with mitral insufficiency and history of paroxysmal atrial fibrillation. Int J Cardiovasc Imaging. 2011
50.
Leung DY, Boyd A, Ng AA, Chi C, Thomas L: Echocardiographic evaluation of left atrial size and function: Current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J. 2008, 156: 1056-64. 10.1016/j.ahj.2008.07.021CrossRefPubMed
51.
Kokubu N, Yuda S, Tsuchihashi K, Hashimoto A, Nakata T, Miura T, Ura N, Nagao K, Tsuzuki M, Wakabayashi C, Shimamoto K: Noninvasive assessment of left atrial function by strain rate imaging in patients with hypertension: a possible benificial effect of Renin-Angiotensin System Inhibition on left atrial function. Hypertens Res. 2007, 30: 13-21. 10.1291/hypres.30.13CrossRefPubMed
Metadata
Title
Novel echocardiographic techniques to assess left atrial size, anatomy and function
Authors
Matteo Cameli
Matteo Lisi
Francesca Maria Righini
Sergio Mondillo
Publication date
01-02-2012
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2012
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/1476-7120-10-4

Other articles of this Issue 1/2012

Cardiovascular Ultrasound 1/2012 Go to the issue

Research

Acute regional improvement of myocardial function after interventional transfemoral aortic valve replacement in aortic stenosis: A speckle tracking echocardiography study

Research

Manual correction of semi-automatic three-dimensional echocardiography is needed for right ventricular assessment in adults; validation with cardiac magnetic resonance

Research

Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction

Research

Evaluation of right and left ventricular function using speckle tracking echocardiography in patients with arrhythmogenic right ventricular cardiomyopathy and their first degree relatives

Research

No relationship between left ventricular radial wall motion and longitudinal velocity and the extent and severity of noncompaction cardiomyopathy

Research

Mitral annular systolic velocity as a marker of preclinical systolic dysfunction among patients with arterial hypertension

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits