Clinical Application of Speckle-tracking Echocardiography in Atherosclerotic Cardiovascular Disease.

Usefulness of Strain Echocardiography in Heart Failure with Preserved Ejection Fraction

A multi-chamber strain-based approach may improve HFpEF diagnosis, phenotyping, and risk stratification, supporting a transition toward a more personalized management strategy.

Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection fraction (cid:2)

Applications of Left Atrial Strain in Cardiovascular Disease: A Comprehensive Review of Recent Evidence

Although left atrial (LA) function is of major clinical importance in cardiovascular diseases, traditional indicators such as LA volume struggle to promptly reflect functional changes. In recent years, the emerging technique of left atrial strain (LAS) has garnered widespread attention. As a quantitative metric based on speckle tracking echocardiography, LAS can detect subtle functional abnormalities in the LA myocardium at an early stage and independently assess atrial reservoir, conduit, and contraction functions beyond volume changes. Numerous recent studies have demonstrated the significant clinical utility of LAS across multiple cardiovascular conditions, including heart failure, atrial fibrillation, hypertension, valvular heart disease, and coronary artery disease. Furthermore, LAS exhibits prognostic value in cardiomyopathies and cancer therapy–related cardiotoxicity. This review summarizes recent advances in LAS across various cardiovascular diseases, objectively evaluates its clinical application prospects and limitations, and outlines future research directions.

Assessment of Left Ventricular Myocardial Fibrosis and Edema in Atrial Fibrillation Using Cardiovascular Magnetic Resonance.

Progressive population aging has driven a steady rise in the incidence of atrial fibrillation (AF), making the management of its long-term prognosis an increasingly important clinical concern. In addition to forming a vicious cycle with progressive atrial dysfunction, AF promotes adverse remodeling and functional impairment of the ventricles, thereby increasing the risk of heart failure. Cardiovascular magnetic resonance (CMR), as the gold standard for evaluating cardiac function, cannot only accurately assess functional abnormalities of the atria and ventricles, but also its quantitative assessment techniques, including T1 mapping, T2 mapping, and extracellular volume (ECV) fraction, enable early and precise quantification of ventricular myocardial pathology. The principal aim of this study is to provide a comprehensive assessment of the left atrium and left ventricle in patients with AF using a one-stop CMR protocol based on multi-parametric quantitative myocardial analysis, providing reliable data for clinical treatment decisions, preoperative assessment, and long-term follow-up.

Impact of cardiac rehabilitation on left atrial function in patients with heart failure reduced ejection fraction

Heart failure with reduced ejection fraction (HFrEF) involves impaired left ventricular systolic function and frequently affects left atrial (LA) performance, which plays a vital role in cardiac output and is an emerging prognostic marker. While cardiac rehabilitation (CR) improves overall cardiac function, its impact on LA function in HFrEF patients remains under-investigated. To evaluate the effect of a structured 12-week CR program on LA function in patients with HFrEF. This prospective observational cohort study included 40 patients with HFrEF (mean age 53.6 ± 10.2 years, 87.5% male), LVEF ≤ 40%, and NYHA class I–II. Participants underwent a 12-week supervised CR program comprising exercise and lifestyle modifications at Ain Shams University Hospitals. Two-dimensional speckle tracking echocardiography was used to assess LA reservoir, conduit, and contractile strain at baseline and post-rehabilitation. Patients with significant valvular disease, residual ischemia, non-sinus rhythm, or poor adherence were excluded. CR significantly improved LA strain parameters: reservoir strain increased from 20.5% ± 9.5 to 23.6% ± 8.0 (p = 0.004), conduit strain from –10.2% ± 6.0 to –11.6% ± 4.6 (p = 0.048), and contractile strain from –10.3% ± 5.8 to –12.0% ± 5.9 (p = 0.020). LVEF improved from 36.4% ± 3.5 to 40.7% ± 5.3 (p < 0.001), while changes in LA size and volume were minimal. A 12-week CR program significantly enhances LA function in HFrEF, indicating potential benefits in atrial mechanics and overall cardiac performance. Larger studies are needed to validate long-term outcomes.

Myocardial Strain in Perioperative Medicine: A Practical Review for Anesthesiologists

A practical framework for the perioperative use of myocardial strain is provided by summarizing the current evidence, clarifying its methodological limitations, simplifying its acquisition and interpretation for non-expert users, distinguishing established clinical applications from future research directions, and identifying the key evidence gaps that must be addressed.