title: The mitral annular displacement by two-dimensional speckle tracking: a new tool in evaluating the left atrial function.
abstract: BACKGROUND
  The methods used to characterize the volume change and the deformation of the left atrium are highly dependent on technical factors and difficult to use in a clinical environment. The aim of this study was to demonstrate that mitral annular displacement by speckle tracking can be an alternative method to studying the longitudinal left atrial function.
  
  
  METHODS
  Ninety study participants (54% men), with a mean age of 53(±15) years, underwent a complete echocardiographic examination, comprising two-dimensional, three-dimensional and tissue Doppler imaging (TDI). They were divided into normal individuals (35) and patients having an abnormal echocardiography (55).
  
  
  RESULTS
  There was a very strong correlation between three-dimensional volumetric function and mitral annular displacement, both for the reservoir (r = 0.78; P < 0.0001) and contractile (r = 0.76; P < 0.0001) functions. The correlation with the longitudinal strain displayed an r = 0.87, P > 0.0001 for the reservoir and r = 0.81, P < 0.0001 for the contractile function. The systolic speed in pulsed TDI and the systolic displacement had an r = 0.83, P < 0.0001. Mitral annular displacement was a very good discriminator for normal versus abnormal participants [area under the curve (AUC) for reservoir = 0.872 and for contractile = 0.843; P < 0.0001], performing less well than three-dimensional (AUC reservoir = 0.892 and contractile = 0.915; P < 0.0001) or deformation (AUC = 0.921 and 0.903 respectively; P < 0.0001), but better than pulsed TDI (AUC = 0.807; P < 0.0001). The percentage error was ±15% for interobserver and ±12% for intraobserver variability. The time taken for displacement analysis was 9 ± 3 s for an experienced cardiologist and 12 ± 4 s for a beginner.
  
  
  CONCLUSIONS
  Mitral annular displacement by speckle tracking is a reliable and fast method to evaluate left atrial function. Given the strength of the correlations with strain parameters, it could be used as a surrogate measure of the deformation of left atrium.
authors.affiliation: Cardiology Department, Brugmann University Hospital, Brussels, Belgium.
authors.forename: Mihai
authors.initials: M
authors.lastname: Strachinaru
authors.forename: Charifa
authors.initials: C
authors.lastname: Annis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Catez
authors.forename: Iris
authors.initials: I
authors.lastname: Jousten
authors.forename: Mirela L
authors.initials: ML
authors.lastname: Lutea
authors.forename: Oana
authors.initials: O
authors.lastname: Pavel
authors.forename: Marielle
authors.initials: M
authors.lastname: Morissens
mesh_terms: D000328:Adult; D000368:Aged; D016279:Atrial Function, Left; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D015588:Observer Variation