Key result
Increasing cumulative cardiovascular risk factors are linked to declining GLS, GCS, and GCSR.
Why the study?
This study evaluated the impact of cardiovascular risk factors on multiple left ventricular strain parameters using four-dimensional XStrain speckle tracking echocardiography in individuals with preserved ejection fraction.
Does the cumulative number of cardiovascular risk factors reduce left ventricular strain parameters in adults with preserved ejection fraction?
Observational (n=500)
Does the cumulative number of cardiovascular risk factors reduce left ventricular strain parameters in adults with preserved ejection fraction?
Answers are grounded in this paper and cite their sources.
Increasing cardiovascular risk factors are associated with subclinical left ventricular dysfunction, as detected by a decline in multiple strain parameters on 4D speckle tracking echocardiography, even when ejection fraction is preserved.
Background: Four-dimensional XStrain speckle tracking echocardiography (4DXStrainSTE) is an advanced cardiac imaging technique that synthesizes speckle tracking echocardiography (STE) data obtained from the apical three-chamber (3CH), four-chamber (4CH), and two-chamber (2CH) views, thereby enabling a comprehensive evaluation of multiple left ventricular strain parameters (MLVSP) within a three-dimensional framework. Methods: This study aimed to evaluate the impact of cardiovascular risk factors (CVRFs) on MLVSP using 4DXStrainSTE. Nine strain parameters were analyzed: global circumferential strain (GCS), GCS rate (GCSR), global radial strain (GRS), and GRS rate (GRSR) at the mitral valve (MV) and papillary muscle (Pap) levels, along with global longitudinal strain (GLS). A total of 500 Indian adults (aged 18–60 years; both sexes) were enrolled. Participants were categorized into four CVRF Risk Categories (1, 2, 3, and 4) according to the cumulative number of risk factors. The inclusion criterion was a four-dimensional left ventricular ejection fraction ≥50%. Results: The effect of CVRF on strain parameters was determined using trend and linearity analyses. Trend analysis across CVRF categories revealed a significant decline in GLS, GCS at the Pap level, and GCSR at the MV level. Pearson’s correlation demonstrated mild-to-moderate linear associations across MLVSP, and multivariate regression analysis identified significant associations of GLS and GCSR at the MV level with GLS across the risk categories. Conclusions: This study provides a comprehensive evaluation of the impact of CVRFs on MLVSP in individuals with preserved ejection fraction.
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Mehrotra et al. (2025) conducted an observational in Cardiovascular risk factors with preserved ejection fraction (n=500). Cardiovascular risk factors vs. Categories of cumulative risk factors (1, 2, 3, and 4) was evaluated on Multiple left ventricular strain parameters (MLVSP). Increasing cumulative cardiovascular risk factors were associated with a significant decline in global longitudinal strain, GCS at the papillary level, and GCSR at the mitral valve level.
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