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01.12.2009 | Research | Ausgabe 1/2009 Open Access

Cardiovascular Ultrasound 1/2009

Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking

Cardiovascular Ultrasound > Ausgabe 1/2009
Matteo Cameli, Maria Caputo, Sergio Mondillo, Piercarlo Ballo, Elisabetta Palmerini, Matteo Lisi, Enzo Marino, Maurizio Galderisi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7120-7-6) contains supplementary material, which is available to authorized users.
Matteo Cameli, Maria Caputo contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

MC, MC, ML, and EP were responsible for the collection of data and drafted the manuscript. PB performed the statistical analysis and revised the manuscript for important intellectual content. SM was responsible for the design of the study and revised the manuscript for important intellectual content. EM provided precious support for the acquisition of data in applying the speckle tracking software to the study of left atrial myocardium. MG also revised the manuscript for important intellectual content. All authors read and approved the final manuscript.



The role of speckle tracking in the assessment of left atrial (LA) deformation dynamics is not established. We sought to determine the feasibility and reference ranges of LA longitudinal strain indices measured by speckle tracking in a population of normal subjects.


In 60 healthy individuals, peak atrial longitudinal strain (PALS) and time to peak longitudinal strain (TPLS) were measured using a 12-segment model for the left atrium. Values were obtained by averaging all segments (global PALS and TPLS) and by separately averaging segments measured in the two apical views (4- and 2-chamber average PALS and TPLS).


Adequate tracking quality was achieved in 97% of segments analyzed. Inter and intra-observer variability coefficients of measurements ranged between 2.9% and 5.4%. Global PALS was 42.2 ± 6.1% (5–95° percentile range 32.2–53.2%), and global TPLS was 368 ± 30 ms (5–95° percentile range 323–430 ms). The 2-chamber average PALS was slightly higher than the 4-chamber average PALS (44.3 ± 6.0% vs 40.1 ± 7.9%, p < 0.0001), whereas no differences in TPLS were found (p = 0.93).


Speckle tracking is a feasible technique for the assessment of longitudinal myocardial LA deformation. Reference ranges of strain indices were reported.
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