Female sex was associated with ≈1.7% greater longitudinal, ≈2.2% greater transverse, and ≈3.2% greater circumferential left ventricular strain compared with men (P<0.0001 for all).
Observational (n=739)
What are the age- and sex-based reference limits for left ventricular myocardial strain and synchrony in healthy adults?
This study establishes age- and sex-specific reference limits for left ventricular strain and synchrony in healthy adults, providing essential normative data for clinical echocardiography.
BACKGROUND: There is rapidly growing interest in applying measures of myocardial strain and synchrony in clinical investigations and in practice; data are limited regarding their reference ranges in healthy individuals. METHODS AND RESULTS: We performed speckle-tracking-based echocardiographic measures of left ventricular myocardial strain and synchrony in healthy adults (n=739, mean age 63 years, 64% women) without cardiovascular disease. Reference values were estimated using quantile regression. Age- and sex-based upper (97.5th quantile) limits were: -14.4% to -17.1% (women) and -14.4 to -15.2% (men) for longitudinal strain; -22.3% to -24.7% (women) and -17.9% to -23.7% (men) for circumferential strain; 121 to 165 ms (women) and 143 to 230 ms (men) for longitudinal segmental synchrony (SD of regional time-to-peak strains); and 200 to 222 ms (women) and 216 to 303 ms (men) for transverse segmental synchrony. In multivariable analyses, women had ≈1.7% greater longitudinal strain, ≈2.2% greater transverse strain, and ≈3.2% greater circumferential strain (P<0.0001 for all) compared with men. Older age and higher diastolic blood pressure, even within the normal range, were associated with worse transverse segmental synchrony (P<0.001). Overall, covariates contributed to ≤12% of the variation in myocardial strain or synchrony in this healthy sample. CONCLUSIONS: We estimated age- and sex-specific reference limits for measures of left ventricular strain and synchrony in a healthy community-based sample, wherein clinical covariates contributed to only a modest proportion of the variation. These data may facilitate the interpretation of left ventricular strain-based measures obtained in future clinical research and practice.
Cheng et al. (Tue,) conducted a observational in Healthy adults without cardiovascular disease (n=739). Speckle-tracking echocardiography was evaluated on Age- and sex-based reference limits for left ventricular myocardial strain and synchrony. Female sex was associated with ≈1.7% greater longitudinal, ≈2.2% greater transverse, and ≈3.2% greater circumferential left ventricular strain compared with men (P<0.0001 for all).