Document Detail


Relationship of multidirectional myocardial strain with radial thickening and ejection fraction and impact of left ventricular hypertrophy: a study in a community-based cohort.
MedLine Citation:
PMID:  23360509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular (LV) systolic strain provides additional prognostic value to LV ejection fraction (LVEF) and wall motion analysis. However, the relationship between myocardial multidirectional strain and LVEF, and the effect of LV hypertrophy on this relationship, are not completely understood especially in unselected populations.
METHODS: LV global longitudinal (εL ) and circumferential (εC ) systolic strain analysis was performed by two-dimensional speckle tracking echocardiography in 215 participants from a community-based study. LV radial wall thickening was measured as global radial strain (εR ), and LVEF was assessed by biplane Simpson's method.
RESULTS: εR was significantly associated with εC (β = -0.56, P < 0.01) and with εL (β = -0.18, P < 0.01). The contribution of εL to εR was especially evident in subjects with lower εC and in presence of LV hypertrophy (β = -0.30, P < 0.01). εL and εC were significantly associated with LVEF (β = -0.36 and β = -0.49, both P < 0.01) independent of LV mass and other confounders, and their interaction significantly improved the prediction of LVEF (R(2) -change = 0.14) but not of εR (R(2) -change = 0.002).
CONCLUSIONS: εR is mainly related to εC with a smaller contribution of εL , which becomes especially evident in subjects with lower εC and in presence of LV hypertrophy. Therefore, radial thickening may not detect subclinical LV longitudinal function reduction in normal ventricles and when εC is preserved. While a reduction in εL has a limited impact on εR , it exerts a greater effect on global LVEF, therefore for a more accurate LVEF prediction both εL and εC need to be considered.
Authors:
Cesare Russo; Zhezhen Jin; Shunichi Homma; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Marco R Di Tullio
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2013-01-30
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  30     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-29     Completed Date:  2014-02-18     Revised Date:  2014-08-04    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  794-802     Citation Subset:  IM    
Copyright Information:
© 2013, Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Echocardiography / methods*,  statistics & numerical data
Elastic Modulus
Elasticity Imaging Techniques / methods*,  statistics & numerical data
Female
Humans
Hypertrophy, Left Ventricular / epidemiology,  physiopathology*,  ultrasonography*
Male
New York / epidemiology
Prevalence
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Stroke Volume*
Grant Support
ID/Acronym/Agency:
R01 NS036286/NS/NINDS NIH HHS; R01 NS29993/NS/NINDS NIH HHS; R01 NS36286/NS/NINDS NIH HHS
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