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:  Publisher    
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 (ε(L) ) and circumferential (ε(C) ) 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 (ε(R) ), and LVEF was assessed by biplane Simpson's method. RESULTS: ε(R) was significantly associated with ε(C) (β = -0.56, P < 0.01) and with ε(L) (β = -0.18, P < 0.01). The contribution of ε(L) to ε(R) was especially evident in subjects with lower ε(C) and in presence of LV hypertrophy (β = -0.30, P < 0.01). ε(L) and ε(C) 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 ε(R) (R(2) -change = 0.002). CONCLUSIONS: ε(R) is mainly related to ε(C) with a smaller contribution of ε(L) , which becomes especially evident in subjects with lower ε(C) and in presence of LV hypertrophy. Therefore, radial thickening may not detect subclinical LV longitudinal function reduction in normal ventricles and when ε(C) is preserved. While a reduction in ε(L) has a limited impact on ε(R) , it exerts a greater effect on global LVEF, therefore for a more accurate LVEF prediction both ε(L) and ε(C) 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     Date:  2013-1-30
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  -     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013, Wiley Periodicals, Inc.
Affiliation:
Department of Medicine, Columbia University Medical Center, New York, New York.
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