Age- and Sex-Based Reference Limits and Clinical Correlates of Myocardial Strain and Synchrony The Framingham Heart Study

作者：Cheng Susan^*; Larson Martin G; McCabe Elizabeth L; Osypiuk Ewa; Lehman Birgitta T; Stanchev Plamen; Aragam Jayashri; Benjamin Emelia J; Solomon Scott D; Vasan Ramachandran S

来源：Circulation-Cardiovascular Imaging, 2013, 6(5): 692-699.

DOI：10.1161/CIRCIMAGING.112.000627

• echocardiography
• left ventricular function
• reference values

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 approximate to 1.7% greater longitudinal strain, approximate to 2.2% greater transverse strain, and approximate to 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.

• 出版日期2013-9