Clinical Relevance of Right Atrial Strain Using Speckle-tracking Echocardiography: Emerging Insights and Future Prospective.

The right atrium (RA) plays a vital role for cardiovascular performance. Recent data have demonstrated the utility of the RA functional assessment as a powerful biomarker for adverse outcomes in various physiological and pathological cardiovascular conditions. Evaluating RA size and function throughout the cardiac cycle (reservoir, conduit, and booster pump) helps for a better understanding of RA response to pressure and volume loading conditions. Basic and advanced echocardiographic modalities provide qualitative and quantitative assessment of the RA size and function. Two-dimensional speckle-tracking echocardiography-derived analysis of RA strain offers a window on all the phases of RA function. The available data are promising for using RA strain in routine echo assessment for the diagnostic and prognostic purposes. For example, in heart failure and pulmonary hypertension, RA strain has a range of 78%-80% sensitivity and 72%-88% specificity. In other indications such as cardiomyopathy and coronary artery disease, RA strain showed moderate accuracy. This review article aims to summarize the current published data on the feasibility and clinical value of RA strain, which may guide its use in a wide scale of patients with various cardiac abnormalities.