ABSTRACT
BACKGROUND: The methods used to characterize the volume change and the deformation of the left atrium are highly dependent on technical factors and difficult to use in a clinical environment. The aim of this study was to demonstrate that mitral annular displacement by speckle tracking can be an alternative method to studying the longitudinal left atrial function. METHODS: Ninety study participants (54% men), with a mean age of 53(±15) years, underwent a complete echocardiographic examination, comprising two-dimensional, three-dimensional and tissue Doppler imaging (TDI). They were divided into normal individuals (35) and patients having an abnormal echocardiography (55). RESULTS: There was a very strong correlation between three-dimensional volumetric function and mitral annular displacement, both for the reservoir (râ=â0.78; Pâ<â0.0001) and contractile (râ=â0.76; Pâ<â0.0001) functions. The correlation with the longitudinal strain displayed an râ=â0.87, Pâ>â0.0001 for the reservoir and râ=â0.81, Pâ<â0.0001 for the contractile function. The systolic speed in pulsed TDI and the systolic displacement had an râ=â0.83, Pâ<â0.0001. Mitral annular displacement was a very good discriminator for normal versus abnormal participants [area under the curve (AUC) for reservoirâ=â0.872 and for contractileâ=â0.843; Pâ<â0.0001], performing less well than three-dimensional (AUC reservoirâ=â0.892 and contractileâ=â0.915; Pâ<â0.0001) or deformation (AUCâ=â0.921 and 0.903 respectively; Pâ<â0.0001), but better than pulsed TDI (AUCâ=â0.807; Pâ<â0.0001). The percentage error was ±15% for interobserver and ±12% for intraobserver variability. The time taken for displacement analysis was 9â±â3âs for an experienced cardiologist and 12â±â4âs for a beginner. CONCLUSION: Mitral annular displacement by speckle tracking is a reliable and fast method to evaluate left atrial function. Given the strength of the correlations with strain parameters, it could be used as a surrogate measure of the deformation of left atrium.