Left Atrial Strain

Lower LA RS and lower LA CS were independently associated with higher all-cause mortality after extensive multivariable adjustment, including adjustment for GLS. Mean LA RS and LA CS values in this HFrEF cohort were substantially lower than normal reference values, reflecting advanced cardiac dysfunction. Each 1% increase in LA CS was associated with a hazard ratio of 0.95 for all-cause mortality in the fully adjusted model. Each 1% increase in LA RS was associated with a hazard ratio of 0.96 for all-cause mortality in the fully adjusted model. The per-unit effect sizes of LA RS and LA CS on mortality risk were modest, supporting their use as continuous risk-refinement tools rather than standalone binary markers. The article contains an internal inconsistency: the abstract and conclusion describe the incremental prognostic value of LA strain as statistically significant, while a results subsection states the improvement was not significant. LA RS reflects reservoir function of the left atrium during ventricular systole, while LA CS reflects contractile function before atrial contraction.