Key result
Global longitudinal strain was highly correlated with global circumferential strain (R2=0.86) and could be accurately estimated using mitral annular plane systolic excursion and left ventricular length (R2=0.85).
Why the study?
Left ventricular global longitudinal and circumferential strain and left atrial strain indicate poor prognosis, but their interrelationships and associations with LV and LA geometry remain unclear.
How do left ventricular and left atrial strain measures relate to each other and to cardiac geometry?
Observational (n=66)
No
How do left ventricular and left atrial strain measures relate to each other and to cardiac geometry?
Left ventricular and left atrial strains are geometrically coupled composite measures of MAPSE and chamber size/function, with GLS and GCS providing largely overlapping information.
Strain measures appear geometrically coupled; leaves open whether MAPSE-based GLS estimation simplifies routine assessment.
Background Left ventricular (LV) global longitudinal strain (GLS) and circumferential strain (GCS), and left atrial (LA) strain (LAS) are indicators of poor prognosis. However, it is unclear how they relate to each other and to LV and LA geometry. The aim of our study was to clarify the relationship between strain and LV and LA geometry to inform clinical and research applications. Methods Patients referred for cardiovascular magnetic resonance imaging were retrospectively identified. Univariable and multivariable linear regression models evaluated associations between GLS, GCS, LAS, LV mass, the volumes and dimensions of the LV and LA, and mitral annular plane systolic excursion (MAPSE). Results In patients (n=66, median [interquartile range] age 62 [53–72] years, 82% male, LV ejection fraction 48 [34–56]%, range 6–69%), GLS associated with both GCS (R 2 =0.86, p<0.001) and LAS (R 2 =0.51, p<0.001), and LAS associated with GCS (R 2 =0.42, p<0.001). GLS, GCS, and LAS were all univariably associated with MAPSE, LV mass, and the volumes and dimensions of the LV and LA (p<0.001 for all). In multivariable analysis, GLS associated with MAPSE and LV length (R 2 =0.85, p<0.001); GCS with MAPSE, LV end-systolic volume, and LV mass (R 2 =0.80, p<0.001); and LAS with LA end-diastolic volume and MAPSE (R 2 =0.67, p<0.001). Conclusions LV and LA strains are geometrically coupled composite measures of MAPSE and of LV and LA size and function, respectively. The composite of these geometric relationships likely explains the excellent prognostic association observed with strain measures. GLS and GCS provide largely overlapping information and should not be treated as distinct measures of longitudinal and circumferential function.
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Fröjdh et al. (2023) conducted an observational in Patients referred for cardiovascular magnetic resonance imaging (n=66). Strain analysis via cardiovascular magnetic resonance imaging was evaluated on Association between global longitudinal strain (GLS) and global circumferential strain (GCS) (R2=0.86, p=<0.001). Global longitudinal strain was highly correlated with global circumferential strain (R2=0.86) and could be accurately estimated using mitral annular plane systolic excursion and left ventricular length (R2=0.85).
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