Normal reference values for left atrial strain and its determinants from a large Korean multicenter registry

Byung Joo Sun, Jae Hyeong Park, Minyeong Lee, Jin Oh Choi, Ju Hee Lee, Mi Seung Shin, Mi Jeong Kim, Hae Ok Jung, Jeong Rang Park, Il Suk Sohn, Hyungseop Kim, Hyung Kwan Kim, Goo Yeong Cho, Jin Sun Park, Chi Young Shim, Sung Hee Shin, Kye Hun Kim, Woo Shik Kim, Seung Woo Park

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29 Citations (Scopus)


BACKGROUND: Left atrial (LA) strain is a novel parameter of LA function. However, its reference value has not been established, and the determining factors for LA strain remain elusive. We aimed to present LA strain with reservoir, conduit, and contractile components and associated parameters in a large-sized group of healthy individuals. METHODS: The present study was from a prospective multicenter registry in South Korea. Subjects who had no history of cardiovascular disease with adequate images were eligible for inclusion. LA reservoir, conduit, and contractile strains (LASRES, LASCD and LASCT, respectively) were measured. Left ventricular global longitudinal strain (LV GLS) and early and late diastolic strain rates (DSRe and DSRa, respectively) were also evaluated. RESULTS: Among a total of 324 subjects (mean age: 49 ± 16 years, 167 females), the mean LASRES, LASCD, and LASCT values were 35.9% ± 10.6%, 21.9% ± 9.3%, and 13.9% ± 3.6%, respectively. Mean LV GLS was-20.4% ± 2.2%, and mean DSRe and DSRa were 1.6 ± 0.4 s-1 and 0.8 ± 0.3 s-1, respectively. With aging, LASRES and LASCD showed significant decreases. Factors showing independent associations with LASRES were age (B =-0.425, p < 0.001), DSRe (B = 4.706, p = 0.001), and LV GLS (B =-1.081, p < 0.001). Age (B =-0.319, p < 0.001), DSRe (B = 4.140, p = 0.002), DSRa (B =-3.409, p = 0.018), and LV GLS (B =-0.783, p < 0.001) showed associations with LASCD. With LASCT, only DSRa showed a correlation (R = 0.277, p < 0.001). CONCLUSIONS: We presented LA strain in a large-sized group of healthy subjects. Age is a significant determinant of LA function. Associations of LA strain with diastolic strain rates and LV GLS reflect cardiac mechanics.

Original languageEnglish
Pages (from-to)186-198
Number of pages13
JournalJournal of Cardiovascular Imaging
Issue number3
Publication statusPublished - 2020

Bibliographical note

Publisher Copyright:
© 2020 Korean Society of Echocardiography.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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