Diastolic wall strain: a simple marker of abnormal cardiac mechanics

Cardiovascular Ultrasound

Research

Jie Peng¹  Kwang-Youn A Kim¹  Marguerite R Irvin²  Donna K Arnett²  Jin Sha²  Senthil Selvaraj³  Lauren Beussink³  Sanjiv J Shah³  Eva E Martinez³  Frank G Aguilar³  Daniel C Lee³  Ateet Patel³ 

[1] Department of Preventive Medicine/Biostatics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;Departments of Epidemiology and Biostatistics, School of Public Health, University of Alabama Birmingham, Birmingham, AL, USA;Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 600, 60611, Chicago, IL, USA;

关键词: Strain;    Speckle-tracking;    Echocardiography;    Cardiac mechanics;    Diastolic dysfunction;    Systolic dysfunction;   

DOI  :  10.1186/1476-7120-12-40

 received in 2014-08-07, accepted in 2014-09-23,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundDiastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics.MethodsWe calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N = 1907 after excluding patients with ejection fraction [EF] < 50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e’) tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N = 35).ResultsIn HyperGEN (age 51 ± 14 years, 59% female, 45% African-American, 57% hypertensive), mean DWS was 0.38 ± 0.05. DWS decreased with increasing comorbidity burden (β-coefficient -0.013 [95% CI -0.015, -0.011]; P < 0.0001). DWS was independently associated with GLS, GCS, GRS, and e’ velocity (adjusted P < 0.05) but not LV chamber compliance (EDV20, P = 0.97). On prospective speckle-tracking analysis, DWS correlated well with GLS, GCS, and GRS (R = 0.61, 0.57, and 0.73, respectively; P < 0.001 for all comparisons). C-statistics for DWS as a diagnostic test for abnormal GLS, GCS, and GRS were: 0.78, 0.79, and 0.84, respectively.ConclusionsDWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e’) tissue velocities but not LV chamber compliance.

【 授权许可】

Unknown   
© Selvaraj et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.