Inhomogeneity of the Left Atrial Strain

Figures

• 

  Figure 1. Schematic presentation of the left atrium. Seven walls were defined: septal, antero-septal, anterior, lateral, posterior, inferior, and superior. Outer ring—basal segments, middle ring—mid-segments, inner circle—superior segments. Red, green and blue punctuated lines correspond to 4-chamber, 2-chamber, and 3-chamber projection of the left atrium, respectively. A4C—apical 4-chamber view, A2C—apical 2-chamber view, A3C—apical 3-chamber view.

• 

  Figure 2. Longitudinal displacement and strain of the left atrium. (A) Apical 4-chamber view, longitudinal displacement curves from six segments are shown. MVO—mitral valve opening. MVC—mitral valve closure. (B) Apical 4-chamber view. Regional and global longitudinal strain from left atrium is shown. MVO—mitral valve opening. MVC—mitral valve closure.

• 

  Figure 3. A bullseye plot of left atrial longitudinal strain and displacement in a healthy 23-year-old male demonstrates a gradient from basal to superior segments. ANT-SEPT—antero-septal wall, SEPT—septal wall, INF—inferior wall, POST—posterior wall, LAT—lateral wall, ANT—anterior wall, SUPERIOR—superior wall. (A) Left atrial regional longitudinal reservoir strain map. The map shows higher strain values in the basal segments compared to the mid-atrium, with the mid-atrium exhibiting higher strain than the superior wall. (B) Left atrial regional longitudinal reservoir displacement map. Longitudinal displacement is greater in the basal segments compared to the mid-atrium, with displacement in the mid-atrium being higher than in the superior segments.

• 

  Figure 4. Regional reservoir strain and longitudinal displacement across the left atrium. (A) Regional reservoir strain (%) across the left atrium. Inferior and septal segments exhibit the highest strain values. Strain in the inferior and septal segments was significantly higher than in the other segments (p < 0.01). (B) Regional reservoir displacement (mm) across the left atrium. Antero-septal displacement was significantly higher than in the other segments (p = 0.04).

• 

  Figure 5. Comparison of average left atrial reservoir strain and displacement between the antero-septal, septal, and inferior segments versus the anterior, lateral, and posterior segments. Average reservoir strain and displacement were significantly higher in the septal and inferior segments compared to the anterior, lateral, and posterior segments (p < 0.00001). The reduction in strain and displacement from the basal to the superior part of the left atrium is depicted with a color gradient.