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


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).


CONCLUSIONS
S and Sr imaging can be considered a robust technique for the assessment of the LAA systolic deformation.
Sevimli
Serdar
S
Department of Cardiology, Medical School Hospital, Ataturk University, 25050 Erzurum, Turkey. drserdarsevimli@hotmail.com
Gundogdu
Fuat
F
Arslan
Sakir
S
Aksakal
Enbiya
E
Gurlertop
Hanefi Yekta
HY
Islamoglu
Yahya
Y
Tas
Hakan
H
Acikel
Mahmut
M
Erol
Mustafa Kemal
MK
Senocak
Huseyin
H
Karakelleoglu
Sule
S
Atesal
Sebahattin
S
Alp
Necip
N
D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013599:Systole