Key result
Healthy multiethnic Brazilians show a mean LVGLS of 19%.
Why the study?
Global longitudinal strain reference values are lacking in diverse populations, as global guidelines often rely on data from homogeneous or geographically distant populations.
What are the reference values for left and right ventricular global longitudinal strain in a healthy Brazilian population, and what factors influence them?
Cross-Sectional (n=1,048)
Yes
What are the reference values for left and right ventricular global longitudinal strain in a healthy Brazilian population, and what factors influence them?
This study establishes normal reference ranges for left and right ventricular global longitudinal strain in a healthy Brazilian population, demonstrating that females have higher strain values and that comorbidities like obesity and hypertension are associated with reduced strain.
Provides initial reference values for ventricular strain in healthy Brazilians; leaves open their prognostic utility pending longitudinal validation.
Background Impaired left ventricular (LV) and right ventricular functions are important predictors of cardiovascular risk. Global longitudinal strain (GLS) provides superior sensitivity for assessing systolic function compared to traditional parameters, enhancing diagnostic accuracy in various cardiac conditions. However, GLS reference values in diverse populations are lacking. Objectives To establish reference values for LVGLS and right ventricular free wall longitudinal strain (RVFWLS) in a Brazilian multiethnic population without cardiovascular risk factors or disease. We also explore how clinical and echocardiographic factors influence GLS distribution, addressing a gap in global guidelines that often rely on data from homogeneous or geographically distant populations. Methods We included 1,048 participants from the ELSA-Brasil cohort who underwent echocardiography with GLS analysis. A healthy subsample (n = 527) was defined by excluding individuals with cardiovascular or renal disease, hypertension, or diabetes to establish GLS reference ranges. The prevalence of abnormal GLS was assessed, and factors associated with reduced LVGLS and RVFWLS were identified. Statistical significance was defined as p < 0.05. Results In the healthy subsample (mean age 50.2 years, 59% female), mean LVGLS was 19.0% (95% confidence interval: 14.3 to 23.8) and RVFWLS was 28.3% (95% confidence interval: 22.3 to 34.3). Females exhibited higher LVGLS and RVFWLS values than males, with no significant age-related differences. Abnormal LVGLS and RVFWLS were observed in 3.8% and 1.6% of participants, respectively. Lower LVGLS was associated with obesity, hypertension, and diabetes; reduced RVFWLS correlated with higher body mass index and LV mass. Conclusions We propose reference values for LVGLS and RVFWLS in a large Brazilian cohort, highlighting associations with cardiovascular comorbidities and ventricular structure.
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Pianca et al. (2025) conducted a cross-sectional in Healthy adults (n=1,048). Echocardiography with Global Longitudinal Strain (GLS) analysis was evaluated on Mean Left Ventricular Global Longitudinal Strain (LVGLS) in the healthy subsample (95% CI 14.3-23.8). In a healthy Brazilian multiethnic population, the mean left ventricular global longitudinal strain was 19.0% and the mean right ventricular free wall longitudinal strain was 28.3%.
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