Background: Left atrial (LA) strain imaging enables the quantitative assessment of LA function. The clinical relevance of these measurements is dependent on the provision of information incremental to the left ventricular (LV) evaluation. The aim of this study was to test the hypothesis that LA pump function but not reservoir function is independent of measurement of LV mechanics.

Methods: Echocardiography was undertaken in a community-based study of 576 participants ≥ 65 years of age with one or more risk factors (e.g., hypertension, diabetes mellitus, obesity). Strain analysis was conducted using a dedicated software package, using R-R gating. LV function was classified as normal in the presence of global longitudinal strain (GLS) (≤ -18%) or global circumferential strain (GCS) (≤ -22%). The associations between GLS or GCS and LA reservoir, conduit, and pump strain were assessed using univariate and multivariate linear regression.

Results: Patients (mean age 71 ± 5 years, 54% women) with reduced GLS had higher blood pressure and rates of diabetes and obesity (P < .05). LA reservoir strain and conduit strain were lower in the group with impaired GLS (38.2 ± 7.3% vs 39.9 ± 6.4% [P = .004] and 18.7 ± 5.7% vs 20.5 ± 5.1% [P < .001], respectively), but there was no difference in LA pump strain (19.5 ± 5.5% vs 19.3 ± 4.6%, P = .72). GLS was independently associated with LA reservoir and conduit strain (P < .05) but not independently associated with LA pump strain (P = .91). Reduced GCS was associated with a larger body mass index, male sex, and diabetes (P < .05). There were no differences in LA reservoir, conduit, and pump strain in patients with normal and abnormal GCS (P > .05).

Conclusions: The application of LA strain is specific to the component measured. LA pump strain is independent of LV mechanics.

Item Type:	Refereed Article
Keywords:	atrial function, left atrium, left ventricle, strain
Research Division:	Medical and Health Sciences
Research Group:	Cardiorespiratory Medicine and Haematology
Research Field:	Cardiology (incl. Cardiovascular Diseases)
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Cardiovascular System and Diseases
Author:	Yang, H (Ms Hilda Yang)
Author:	Wang, Y (Ms Ying Wang)
Author:	Nolan, M (Mr Mark Nolan)
Author:	Negishi, T (Dr Tomoko Negishi)
Author:	Negishi, K (Dr Kazuaki Negishi)
Author:	Marwick, TH (Professor Tom Marwick)
ID Code:	121389
Year Published:	2017
Web of Science® Times Cited:	5
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2017-09-27
Last Modified:	2018-06-22
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