Atrial Strain Imaging after Repair of Tetralogy of Fallot: A Systematic Review

Ultrasound Med Biol. 2019 Aug;45(8):1896-1908. doi: 10.1016/j.ultrasmedbio.2019.04.032. Epub 2019 May 30.


We performed a systematic review of the literature on assessment of right atrial (RA) and left atrial (LA) deformation by myocardial strain imaging in patients with repaired tetralogy of Fallot. Ten studies with a total of 536 adolescent and adult patients were included, of which 5 evaluated RA deformation, 2 studied LA deformation and 3 assessed deformation of both atria. Seven studies used speckle tracking echocardiography, 2 employed tissue Doppler imaging and 1 applied cardiac magnetic resonance feature tracking. Main findings were (i) reduced regional and/or global RA and LA strain and strain rate consistent with reduced conduit, reservoir and contractile function of the two atria in patients; (ii) associations between RA and LA deformation indices suggestive of atrial-atrial interaction; and (iii) relationships between RA deformation and indices of right ventricular systolic and diastolic function. The lack of data on prognostic value of atrial strain is an important knowledge gap.

Keywords: Atrial strain; Systematic review; Tetralogy of Fallot.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Echocardiography / methods*
  • Heart Atria / diagnostic imaging
  • Heart Atria / physiopathology
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Tetralogy of Fallot / surgery*