Speckle-Tracking Echocardiography

Two-dimensional speckle-tracking echocardiography enables direct quantification of left atrial myocardial deformation through strain measures. Left atrial speckle tracking was performed in three apical views using QRS onset as the reference point with R-R gating. All speckle-tracking analyses were performed offline by a single trained observer to improve measurement consistency. Approximately 25% of referred patients were excluded because echocardiographic image quality was insufficient for left atrial speckle-tracking analysis, reflecting real-world challenges in HFrEF populations.