Research

Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking

Matteo Cameli^1* , Maria Caputo^1* , Sergio Mondillo¹ , Piercarlo Ballo² , Elisabetta Palmerini¹ , Matteo Lisi¹ , Enzo Marino³ and Maurizio Galderisi⁴

¹  Department of Cardiovascular Diseases, University of Siena, Siena, Italy

²  Cardiology Operative Unit, S Andrea Hospital, La Spezia, Italy

³  GE Healthcare, Milan, Italy

⁴  Cardioangiology Unit with CCU, Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy

author email corresponding author email* Contributed equally

Cardiovascular Ultrasound 2009, 7:6doi:10.1186/1476-7120-7-6

Published:	8 February 2009

Abstract

Background

The role of speckle tracking in the assessment of left atrial (LA) deformation dynamics is not established. We sought to determine the feasibility and reference ranges of LA longitudinal strain indices measured by speckle tracking in a population of normal subjects.

Methods

In 60 healthy individuals, peak atrial longitudinal strain (PALS) and time to peak longitudinal strain (TPLS) were measured using a 12-segment model for the left atrium. Values were obtained by averaging all segments (global PALS and TPLS) and by separately averaging segments measured in the two apical views (4- and 2-chamber average PALS and TPLS).

Results

Adequate tracking quality was achieved in 97% of segments analyzed. Inter and intra-observer variability coefficients of measurements ranged between 2.9% and 5.4%. Global PALS was 42.2 ± 6.1% (5–95° percentile range 32.2–53.2%), and global TPLS was 368 ± 30 ms (5–95° percentile range 323–430 ms). The 2-chamber average PALS was slightly higher than the 4-chamber average PALS (44.3 ± 6.0% vs 40.1 ± 7.9%, p < 0.0001), whereas no differences in TPLS were found (p = 0.93).

Conclusion

Speckle tracking is a feasible technique for the assessment of longitudinal myocardial LA deformation. Reference ranges of strain indices were reported.