Cargando…

Diastolic wall strain: a simple marker of abnormal cardiac mechanics

BACKGROUND: Diastolic 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 cl...

Descripción completa

Detalles Bibliográficos
Autores principales: Selvaraj, Senthil, Aguilar, Frank G, Martinez, Eva E, Beussink, Lauren, Kim, Kwang-Youn A, Peng, Jie, Lee, Daniel C, Patel, Ateet, Sha, Jin, Irvin, Marguerite R, Arnett, Donna K, Shah, Sanjiv J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197332/
https://www.ncbi.nlm.nih.gov/pubmed/25277882
http://dx.doi.org/10.1186/1476-7120-12-40
_version_ 1782339607147315200
author Selvaraj, Senthil
Aguilar, Frank G
Martinez, Eva E
Beussink, Lauren
Kim, Kwang-Youn A
Peng, Jie
Lee, Daniel C
Patel, Ateet
Sha, Jin
Irvin, Marguerite R
Arnett, Donna K
Shah, Sanjiv J
author_facet Selvaraj, Senthil
Aguilar, Frank G
Martinez, Eva E
Beussink, Lauren
Kim, Kwang-Youn A
Peng, Jie
Lee, Daniel C
Patel, Ateet
Sha, Jin
Irvin, Marguerite R
Arnett, Donna K
Shah, Sanjiv J
author_sort Selvaraj, Senthil
collection PubMed
description BACKGROUND: Diastolic 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. METHODS: We 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). RESULTS: In 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 (EDV(20), 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. CONCLUSIONS: DWS, 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.
format Online
Article
Text
id pubmed-4197332
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-41973322014-10-16 Diastolic wall strain: a simple marker of abnormal cardiac mechanics Selvaraj, Senthil Aguilar, Frank G Martinez, Eva E Beussink, Lauren Kim, Kwang-Youn A Peng, Jie Lee, Daniel C Patel, Ateet Sha, Jin Irvin, Marguerite R Arnett, Donna K Shah, Sanjiv J Cardiovasc Ultrasound Research BACKGROUND: Diastolic 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. METHODS: We 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). RESULTS: In 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 (EDV(20), 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. CONCLUSIONS: DWS, 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. BioMed Central 2014-10-03 /pmc/articles/PMC4197332/ /pubmed/25277882 http://dx.doi.org/10.1186/1476-7120-12-40 Text en © 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.
spellingShingle Research
Selvaraj, Senthil
Aguilar, Frank G
Martinez, Eva E
Beussink, Lauren
Kim, Kwang-Youn A
Peng, Jie
Lee, Daniel C
Patel, Ateet
Sha, Jin
Irvin, Marguerite R
Arnett, Donna K
Shah, Sanjiv J
Diastolic wall strain: a simple marker of abnormal cardiac mechanics
title Diastolic wall strain: a simple marker of abnormal cardiac mechanics
title_full Diastolic wall strain: a simple marker of abnormal cardiac mechanics
title_fullStr Diastolic wall strain: a simple marker of abnormal cardiac mechanics
title_full_unstemmed Diastolic wall strain: a simple marker of abnormal cardiac mechanics
title_short Diastolic wall strain: a simple marker of abnormal cardiac mechanics
title_sort diastolic wall strain: a simple marker of abnormal cardiac mechanics
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197332/
https://www.ncbi.nlm.nih.gov/pubmed/25277882
http://dx.doi.org/10.1186/1476-7120-12-40
work_keys_str_mv AT selvarajsenthil diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT aguilarfrankg diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT martinezevae diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT beussinklauren diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT kimkwangyouna diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT pengjie diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT leedanielc diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT patelateet diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT shajin diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT irvinmargueriter diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT arnettdonnak diastolicwallstrainasimplemarkerofabnormalcardiacmechanics
AT shahsanjivj diastolicwallstrainasimplemarkerofabnormalcardiacmechanics