Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years

Menting, Myrthe E.; McGhie, Jackie; Koopman, Laurens P.; Vletter, Wim B.; Helbing, Willem A.; Bosch, Annemien E. van den; Roos‐Hesselink, Jolien W.

doi:10.1111/echo.13323

Cited by 59 publications

(76 citation statements)

References 32 publications

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“…Previous cross‐sectional studies reported anthropometric and hemodynamic determinants of LS such as BMI, heart rate, and blood pressure . It was also shown that men have significantly lower LS compared to women even in healthy subjects without cardiovascular risk factors .…”

Section: Discussionmentioning

confidence: 97%

Temporal changes in left ventricular longitudinal strain in general population: Clinical correlates and impact on cardiac remodeling

et al. 2019

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Background Recent studies in patients and general population have reported the role of left ventricular (LV) longitudinal strain (LS) as an independent predictor of outcome. However, there are few data on changes in LS over time. We therefore investigated in a general population clinical correlates of temporal changes in LS. We also explored the potential correlation between temporal changes in LV volumes and LS. Methods and Results We measured LV end‐systolic (ESV) and end‐diastolic (EDV) volumes by conventional echocardiography and LS by 2D speckle tracking in 627 participants (mean age 50.6 years, 51.4% women; 41.3% hypertensives) at baseline and after 4.7 years. For statistical analysis, we used the absolute values of LS. In stepwise regression, the magnitude of the decrease in all LV LS indexes over time was greater in men than in women (P < 0.0001). Higher baseline mean arterial pressure (MAP), a larger longitudinal increase in MAP, and stopping diuretic treatment during follow‐up were related to larger decreases in LS indexes. In multivariable‐adjusted analysis, we observed an inverse correlation between baseline ESV and LV LS (P ≤ 0.0017). Similarly, lower baseline LS and a larger decrease in LS over time were correlated with a lesser longitudinal decrease in ESV (P ≤ 0.0004). Conclusions A significant decrease in LS over time was associated with male sex, higher baseline MAP, ∆MAP, and alteration in antihypertensive treatment. We suggested an interaction between a longitudinal decrease in LV deformation and adverse cardiac remodeling, while underscoring the importance of deformation analysis based on LS assessment in patients at risk.

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Section: Discussionmentioning

confidence: 97%

Temporal changes in left ventricular longitudinal strain in general population: Clinical correlates and impact on cardiac remodeling

et al. 2019

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“…The effect of aging on GLS has remained controversial. Menting et al studied a healthy population 20–72 years old and found that GLS was reduced in individuals older than 55 years. Similar results were obtained by Sun et al and Dalen et al Conversely, analysis from the Framingham Heart Study, including healthy individuals 45–84 years old, did not find age‐associated changes in GLS .…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported that aging, 10 obesity, 11 and blood pressure (BP) 12 can reduce LV LS, but these findings have not been consistent across population studies. [10][11][12][13][14][15] Moreover, the available population studies were not controlled for physical fitness, and thus it remains unclear if LS is related to functional capacity in patients without HF.…”

Section: Introductionmentioning

confidence: 99%

Myocardial longitudinal strain, fitness, and heart failure risk factors in young adults

et al. 2020

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Aims To investigate the relationship between fitness, heart failure (HF) risk factors (age, blood pressure, and obesity), and global/regional myocardial longitudinal strain in young adults undergoing stress testing. Methods Individuals 25–55 years old without any significant medical history, not taking medications, and with a normal maximal stress echocardiogram were eligible. Global and regional longitudinal strain (LS) was evaluated by 2D speckle tracking echocardiography. Results One hundred and seventy patients were included, of which 60% were males. The mean age was 43 years old, 49% had optimal blood pressure, and 30% were obese. On average, patients achieved 10.5 (3) METS, and the global LS was −19.9 (3.1) %. Reduced fitness was associated with decreased global longitudinal strain (GLS). Those in the top GLS quartile walked on average 1 minute and 21 seconds longer compared with the lowest quartile (P < .001). The effect of fitness on LS was preferential to the mid and apex, such that there was an apex‐to‐base gradient. Obesity was also independently associated with reduced GLS. However, the reduction in LS in obese individuals was more prominent at the base and mid‐walls with relative sparing of the apex. Similar to fitness, aging was also associated with an increase in the apex‐to‐base gradient of LS. Furthermore, diastolic filling parameters correlated distinctively with regional LS. Conclusions In young adults without cardiovascular disease, low fitness and obesity are independently associated with reduced left ventricular longitudinal strain. There is a differential effect of HF risk factors on regional longitudinal function.

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“…Healthy volunteers were enrolled in 2014–2015 for this prospective cross‐sectional study and stratified into 5 age groups: 20–29, 30–39, 40–49, 50–59, 60–72 years (n ≥ 28 for each group, each 50% female). Details have been published earlier . Briefly, subjects were recruited via advertisement and underwent a questionnaire regarding medical history and current health status, physical examination, venous blood sampling, 12‐lead ECG, and an echocardiogram.…”

Section: Methodsmentioning

confidence: 99%

In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis

et al. 2018

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Purpose Left atrial ( LA ) dilatation is predictive for complications in a multitude of cardiac diseases; therefore, adequate assessment is essential. Technological advances have made it possible to quantify LA function with Speckle Tracking Echocardiography ( STE ); however, there are currently no recommendations for normal values with regard to LA function. We aimed to assess LA myocardial and volumetric function in a healthy cohort and investigate correlations with baseline characteristics. Methods This prospective cohort study included 147 (aged 20–72) healthy individuals and assessed LA volumetric function using maximum, minimum and pre‐a‐wave volumes and myocardial function using reservoir function using peak strain in LA relaxation ( LA ‐strain), conduit function using peak strain rate in early LA contraction ( LA ‐ SR e) and pump function using peak strain rate in late LA contraction ( LA ‐ SR a). Results Mean LA ‐strain was 39.7 ± 6.2%, LA ‐ SR e −2.78 ± 0.62 s −1 and LA ‐ SR a −2.56 ± 0.62 s −1 . Subjects were divided into 5 age decades (each 50% female). LA ‐strain and LA ‐ SR e were lower in the oldest groups, whereas LA ‐ SR a was higher. LA ‐ SR a was higher in males(−2.69 ± 0.68 s −1 vs −2.42 ± 0.52 s −1 ). Age‐specific values are provided. Age proved to be an independent predictor for LA ‐ SR a after correction for blood pressure and heart rate. LA expansion index and passive emptying fraction decreased with age, while active emptying fraction increased with age. LA maximum volume did not increase with age. Conclusion This study provides normal values for the three phasic functions of the LA , assessed with STE and volumetric function. Our results suggest the need for age‐specific reference ranges, and normal values for this cohort have been calculated.

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Normal myocardial strain values using 2D speckle tracking echocardiography in healthy adults aged 20 to 72 years

Abstract: Our study resulted in normative LV GLS values assessed with QLAB 10. Male sex, higher BSA, and higher blood pressure negatively influence GLS. Therefore, these factors should be taken into account for strain interpretation in clinical practice.

Cited by 59 publications

References 32 publications

Temporal changes in left ventricular longitudinal strain in general population: Clinical correlates and impact on cardiac remodeling

Temporal changes in left ventricular longitudinal strain in general population: Clinical correlates and impact on cardiac remodeling

Myocardial longitudinal strain, fitness, and heart failure risk factors in young adults

In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis

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