title: Normal values and clinical relevance of left atrial myocardial function analysed by speckle-tracking echocardiography: multicentre study.
abstract: OBJECTIVE
  The aim of this multicentre study was to determine the normal range and the clinical relevance of the myocardial function of the left atrium (LA) analysed by 2D speckle-tracking echocardiography (2DSTE).
  
  
  RESULTS
  We analysed 329 healthy adult subjects prospectively included in 10 centres and a validation group of 377 patients with left ventricular diastolic dysfunction (LVDD). LA myocardial function was analysed by LA strain rate peak during LA contraction (LA-SRa) and LA strain peak during LA relaxation (LA-Strain). The range of values of LA myocardial function in healthy subjects was LA-SRa -2.11 ± 0.61 s(-1) and LA-Strain 45.5 ± 11.4%, and the lowest expected values of these LA analyses (calculated as -1.96 SD from the mean of healthy subjects) were LA-SRa -0.91 s(-1) and LA-Strain 23.1%. Concerning the clinical relevance of these LA myocardial analyses, LA-SRa and LA-Strain detected subtle LA dysfunction in patients with LVDD, even though LA volumetric measurements were normal. In addition, in these patients we found that the functional class (dyspnoea-NYHA classification) was inversely related to both LA-Strain and LA-SRa.
  
  
  CONCLUSIONS
  In the present multicentre study analysing a large cohort of healthy subjects and patients with LVDD, the normal range and the clinical relevance of the myocardial function of the LA using 2DSTE have been determined.
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany daniel-armando.morris@charite.de.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Morris
authors.affiliation: School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Krisper
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Köhncke
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Tarek
authors.initials: T
authors.lastname: Bekfani
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Carstensen
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Hassfeld
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Dorenkamp
authors.affiliation: School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Otani
authors.affiliation: Nagano Children's Hospital, Azumino, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Takigiku
authors.affiliation: Tenri Hospital, Tenri, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Izumi
authors.affiliation: Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yuda
authors.affiliation: Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Konomi
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohte
authors.affiliation: Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.affiliation: Meoclinic, Berlin, Germany.
authors.forename: Engin
authors.initials: E
authors.lastname: Osmanoglou
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: York
authors.initials: Y
authors.lastname: Kühnle
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Hans-Dirk
authors.initials: HD
authors.lastname: Düngen
authors.affiliation: Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakatani
authors.affiliation: School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.affiliation: Department of Cardiology, Charité University Hospital (Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin), Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Leif-Hendrik
authors.initials: LH
authors.lastname: Boldt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016279:Atrial Function, Left; D015992:Body Mass Index; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005858:Germany; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Echocardiography; Left atrial; Speckle tracking; Strain