Association of the active and passive components of left atrial deformation with left ventricular function

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 P = .004] and 18.7 ± 5.7% vs 20.5 ± 5.1% [P P = .72). GLS was independently associated with LA reservoir and conduit strain (P P = .91). Reduced GCS was associated with a larger body mass index, male sex, and diabetes (P P > .05).Conclusions: The application of LA strain is specific to the component measured. LA pump strain is independent of LV mechanics