Dear Reader,

For this June 2023 issue, I have selected the paper by Dr M Ribeiro Silva and co-authors under the supervison of Dr R Fontes-Carvalho from the Cardiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, and the University of Porto in Portugal [1]. The reason for me to select this paper is the combination of a review and in particular the described tips and tricks for daily practice.

As the authors indicate in their summary, left atrium (LA) function plays a key role in global cardiac performance as it modulates left ventricle (LV) filling through three main functions: the LA reservoir, conduit and booster pump. Given the interdependence between the LA and the LV, it is known that LA dimension and/or LA function can be used as a surrogate for LV diastolic function. Also, LA deformation analysis using 2-dimensional (2D) speckle tracking echocardiography (STE) strain has emerged as a promising non-invasive technique that can help to estimate LV filling pressures (LVFP) and diagnose heart failure with preserved ejection fraction (HFpEF); see also the recently proposed 2022 European Association of Cardiovascular Imaging (EACVI) consensus document, which included LA reservoir strain as an additive parameter to estimate LVFP.

In this article the authors review the latest evidence regarding the role of LA strain in the assessment and management of LV diastolic dysfunction (LVDD) and HFpEF, and provide a clinical guide with tips and tricks to use LA strain as a new technique to help to estimate LVFP, as presented in the Fig. 1 below, which is Fig. 5 from their paper. At the same time, the authors also clearly indicate in their manuscript the limitations of left atrial deformation analysis.

Fig. 1
figure 1

Tips and tricks to perform LA deformation analysis in clinical practice

Full size image

With this June 2023 choice, I would like to thank you, our readership, again for your interest and would like to wish you much reading pleasure with this paper and all the other very interesting papers published in this June 2023 issue of the International Journal of Cardiovascular Imaging.

Johan HC Reiber, PhD

Editor-in-chief