Key result
Exercise stress echocardiography associated with ~2-fold shorter time-to-peak strain in normal LV function.
Observational (n=46)
In patients with normal left ventricular function and no coronary artery disease, exercise stress echocardiography demonstrates an increase in peak strain and a significant shortening of time-to-peak strain, providing reference data for future studies.
Provides reference strain timing values in normal LV; hypothesis-generating for ischemia detection before clinical use.
OBJECTIVES: Exercise stress echocardiography is a widely used modality for the diagnosis and follow-up of patients with coronary artery disease. During the last decade, speckle tracking imaging has been used increasingly for accurate evaluation of cardiac function. This work aimed to assess speckle-tracking imaging parameters during nonischemic exercise stress echocardiography. METHODS: During 2011 to 2014 we studied 46 patients without history of coronary artery disease, who completed exercise stress echocardiography protocol, had normal left ventricular function, a nonischemic response, and satisfactory image quality. These exams were analyzed with speckle-tracking imaging software at rest and at peak exercise. Peak strain and time-to-peak strain were measured at rest and after exercise. Clinical follow-up included a telephone contact 1 to 3 years after stress echo exam, confirming freedom from coronary events during this time. RESULTS: Global and regional peak strain increased following exercise. Time-to-peak global and regional strain and time-to-peak strain adjusted to the heart rate were significantly shorter in all segments after exercise. Rest-to-stress ratio of time-to-peak strain adjusted to the heart rate was 2.0 to 2.8. CONCLUSIONS: Global and regional peak strain rise during normal exercise echocardiography. Peak global and regional strain occur before or shortly after aortic valve closure at rest and after exercise, and the delay is more apparent at the basal segments. Time-to-peak strain normally shortens significantly during exercise; after adjustment to heart rate it shortens by a ratio of 2.0 to 2.8. These data may be useful for interpretation of future exercise stress speckle-tracking echocardiography studies.
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Leitman et al. (2016) conducted an observational in Normal left ventricular function without coronary artery disease (n=46). Exercise stress echocardiography vs. Rest was evaluated on Speckle-tracking imaging parameters (peak strain and time-to-peak strain). Exercise stress echocardiography in patients with normal left ventricular function significantly shortens time-to-peak strain, with a rest-to-stress ratio of 2.0 to 2.8 after heart rate adjustment.
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