Early Detection of Regional and Global Left Ventricular Myocardial Function Using Strain and Strain-rate Imaging in Patients with Metabolic Syndrome

Abstract

Background:Strain and strain-rate imaging (SRI) have been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. The aim of this study was to evaluate the regional and global left ventricular (LV) myocardial function in metabolic syndrome (MS) with SRI so that we can provide more myocardial small lesions in patients with MS, which is robust and reliable basis for early detection of LV function.Methods:Thirty-nine adults with MS were enrolled in the study. There was a control group of 39 healthy adults. In addition to classic echocardiographic assessment of LV global functional changes, SRI was used to evaluate regional and global LV function. Including: Peak systolic strain (S), peak systolic strain-rate (SR-s), peak diastolic strain-rate (SR-e).Results:There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function. On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function. Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.Conclusion:In MS with normal LV ejection fraction, there was regional myocardial dysfunction, risk factors contributed to the impairment of systolic and diastolic function of the regional myocardium. Assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.

Correlation between myocardial deformation on three‐dimensional speckle tracking echocardiography and cardiopulmonary exercise testing

“…Interestingly, the resting EF exhibited a weak correlation with exercise capacity, while GLS, another assessment of myocardial systolic function, showed a relationship with peakVO 2 ( r = .32, P < .001) (Figure ). Nevertheless, we consider that EF was accurately measured in 3D echocardiography; EF is a markedly load‐dependent parameter that cannot accurately assess the functional status of the heart . However, the GLS is a reproducible parameter of global systolic function that is less influenced by load and has been demonstrated to have superior prognostic properties to LVEF in major observational studies .…”

“…Nevertheless, we consider that EF was accurately measured in 3D echocardiography; EF is a markedly load-dependent parameter that cannot accurately assess the functional status of the heart. 26 However, the GLS is a reproducible parameter of global systolic function that is less influenced by load and has been demonstrated to have superior prognostic properties to LVEF in major observational studies. 27 Our results were consistent with the study 3D EF = three-dimensional ejection fraction; LA index = left atrium volume index; EDT = early diastolic peak velocity deceleration time; E/e = ratio of early diastolic peak velocity to the early diastolic peak velocity of the mitral annulus; E/V p = the ratio of early mitral diastolic peak velocity to the mitral flow propagation velocity; GLS = global longitudinal systolic peak strain; GCS = global circumferential systolic peak strain; GRS = global radial systolic peak strain; 25%(50%) Untwist = the amount of untwisting at 25% (50%) of the untwisting duration.…”

Assessment of Early Left Ventricular Diastolic Dysfunction in Patients with Metabolic Syndrome by 2D Speckle Tracking Echocardiography

“…These findings were compatible with the study of Qin Wang et al (12) who studied 39 metabolic syndrome subjects with normal ejection fraction and 39 control subjects of similar age and found that; significant differences were observed between MS and the control group in most of the parameters of Strain, SR (s -1 ), SRIVR (s -1 ) in LV function and shows that assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.…”

“…These findings were similar to Qin Wang and his colleagues (12) who studied early detection of regional and global left ventricular myocardial function, that shows no significant difference was observed among the groups regarding age, sex, heart rate. There were significant differences in W.…”

“…These findings were similar to Qin Wang and his colleagues (12) who studied early detection of regional and global left ventricular myocardial function in (39) patients with metabolic syndrome and (39) control subjects of similar age and found that; There was no statistically significant difference between the two groups as regard LV ejection fraction (EF) and fractional shortening (FS).…”