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September 6, 2026BMC Cardiovascular DisordersOpen Access

Baseline 3DE LASr predicts ~30% higher odds of 6-month LVEF recovery per 1% increase.

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Why the study?

Does left atrial strain measured by 3DE and 2DE predict LVEF recovery in patients with newly diagnosed HFrEF?

Population

126 consecutive patients hospitalized with newly diagnosed heart failure with reduced ejection fraction…

Design

Cohort, Offline analyses were independently performed in a blinded manner by…

Follow-up

6 months for primary endpoint, up to December 31, 2024 for…

Key result

Baseline left atrial strain reservoir measured by 3D echocardiography independently predicted left ventricular ejection fraction recovery at 6 months (OR 1.30 per 1% increase).

Authors

TPThao Thi Thanh PhamJLJong Min LeeDNDung Viet Nguyen

Discussion

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Overview

3D LASr was associated with LVEF recovery in new HFrEF; extends 2D data but leaves open clinical adoption.

Key Points

  • To evaluate and compare the prognostic value of left atrial strain reservoir measured by 2D versus 3D echocardiography for predicting left ventricular ejection fraction recovery and survival in patients with newly diagnosed heart failure with reduced ejection fraction.
  • Prospective single-center cohort study of 126 consecutive patients hospitalized with newly diagnosed heart failure with reduced ejection fraction (HFrEF).
  • Baseline left atrial strain reservoir (LASr) was measured using 2D and 3D echocardiography, with left ventricular ejection fraction (LVEF) reassessed at 6-month follow-up to classify patients into improved (HFimpEF) or persistent HFrEF.
  • At 6 months, 36 of 126 patients (28.6%) achieved HFimpEF; both 2DE LASr (OR per 1% increase: 1.25; 95% CI, 1.08–1.45; p = 0.004) and 3DE LASr (OR: 1.30; 95% CI, 1.11–1.53; p = 0.001) were independently associated with LVEF recovery.
  • Adding 3DE LASr to the 2DE LASr model significantly improved predictive performance (ΔLR χ² = 5.33; p = 0.021), and only 3DE LASr remained an independent predictor when both modalities were included together.
  • Baseline LASr below median values (<16.5% for 2DE, p = 0.019; <15.5% for 3DE, p = 0.004) was significantly associated with lower cumulative survival on Kaplan–Meier analysis.

Study Design

Type

Cohort (n=126)

Multicenter

No

Structured PICO

Does left atrial strain measured by 3DE and 2DE predict LVEF recovery in patients with newly diagnosed HFrEF?

P
Population
126 patients hospitalized with newly diagnosed heart failure with reduced ejection fraction (LVEF < 40%), followed for 6 months to assess LVEF recovery.
E
Exposure
Measurement of Left Atrial Strain reservoir (LASr) using three-dimensional echocardiography (3DE) and two-dimensional echocardiography (2DE)
O
Outcome
Improvement of ejection fraction (HFimpEF) at 6 monthssurrogate

Main Result

Odds Ratio: 1.3 (95% CI 1.11–1.53)

p-value: p=0.001

Left atrial strain measured by 3D echocardiography provides incremental prognostic value over 2D echocardiography for predicting LVEF recovery and survival in patients with newly diagnosed HFrEF.

Limitations

  • Single-center study with a small sample size.
  • Unable to compare findings with advanced assessment methods such as cardiac CT or MRI.
  • Formal inter- and intra-observer reproducibility metrics were not systematically quantified.
  • Only LA reservoir strain was assessed, excluding LA conduit and booster pump functions.

Cite This Study

Pham et al. (2026) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=126). Left atrial strain reservoir (LASr) by 3D echocardiography vs. Lower LASr was evaluated on Improvement of ejection fraction (HFimpEF) at 6 months (OR 1.30, 95% CI 1.11-1.53, p=0.001). Baseline left atrial strain reservoir measured by 3D echocardiography independently predicted left ventricular ejection fraction recovery at 6 months (OR 1.30 per 1% increase).

synapsesocial.com/papers/6a9d1e6328139818eab213aehttps://doi.org/10.1186/s12872-026-06578-y
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left Atrial Strain Predicts Outcome in Populations With and Without Specific Cardiovascular Diseases Across the Range of Ejection Fraction: A Systematic Review and Meta‐Analysis2026 · 1 citations
  2. 2The effect of left atrial reservoir strain on right ventricular dysfunction in left-sided heart failure2025
  3. 3Correlates and prognostic value of left atrial strain in transcatheter edge-to-edge repair for degenerative mitral regurgitation2025 · 1 citations
  4. 4Prognostic value of left atrial reservoir strain for major adverse cardiovascular events in coronary artery disease2026
  5. 5Left Atrial Reservoir Strain in Cardiovascular and Systemic Disease: Advances and Clinical Applications From Physiology to Practice2025 · 9 citations