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Diastolic wall strain: a simple marker of abnormal cardiac mechanics.

Publication ,  Journal Article
Selvaraj, S; Aguilar, FG; Martinez, EE; Beussink, L; Kim, K-YA; Peng, J; Lee, DC; Patel, A; Sha, J; Irvin, MR; Arnett, DK; Shah, SJ
Published in: Cardiovasc Ultrasound
October 3, 2014

BACKGROUND: Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics. METHODS: We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] <50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e') tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N=35). RESULTS: In HyperGEN (age 51 ± 14 years, 59% female, 45% African-American, 57% hypertensive), mean DWS was 0.38 ± 0.05. DWS decreased with increasing comorbidity burden (β-coefficient -0.013 [95% CI -0.015, -0.011]; P<0.0001). DWS was independently associated with GLS, GCS, GRS, and e' velocity (adjusted P<0.05) but not LV chamber compliance (EDV20, P=0.97). On prospective speckle-tracking analysis, DWS correlated well with GLS, GCS, and GRS (R=0.61, 0.57, and 0.73, respectively; P<0.001 for all comparisons). C-statistics for DWS as a diagnostic test for abnormal GLS, GCS, and GRS were: 0.78, 0.79, and 0.84, respectively. CONCLUSIONS: DWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e') tissue velocities but not LV chamber compliance.

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Published In

Cardiovasc Ultrasound

DOI

EISSN

1476-7120

Publication Date

October 3, 2014

Volume

12

Start / End Page

40

Location

England

Related Subject Headings

  • Ventricular Dysfunction, Left
  • United States
  • Stress, Mechanical
  • Sensitivity and Specificity
  • Risk Factors
  • Reproducibility of Results
  • Prevalence
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
 

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Selvaraj, S., Aguilar, F. G., Martinez, E. E., Beussink, L., Kim, K.-Y., Peng, J., … Shah, S. J. (2014). Diastolic wall strain: a simple marker of abnormal cardiac mechanics. Cardiovasc Ultrasound, 12, 40. https://doi.org/10.1186/1476-7120-12-40
Selvaraj, Senthil, Frank G. Aguilar, Eva E. Martinez, Lauren Beussink, Kwang-Youn A. Kim, Jie Peng, Daniel C. Lee, et al. “Diastolic wall strain: a simple marker of abnormal cardiac mechanics.Cardiovasc Ultrasound 12 (October 3, 2014): 40. https://doi.org/10.1186/1476-7120-12-40.
Selvaraj S, Aguilar FG, Martinez EE, Beussink L, Kim K-YA, Peng J, et al. Diastolic wall strain: a simple marker of abnormal cardiac mechanics. Cardiovasc Ultrasound. 2014 Oct 3;12:40.
Selvaraj, Senthil, et al. “Diastolic wall strain: a simple marker of abnormal cardiac mechanics.Cardiovasc Ultrasound, vol. 12, Oct. 2014, p. 40. Pubmed, doi:10.1186/1476-7120-12-40.
Selvaraj S, Aguilar FG, Martinez EE, Beussink L, Kim K-YA, Peng J, Lee DC, Patel A, Sha J, Irvin MR, Arnett DK, Shah SJ. Diastolic wall strain: a simple marker of abnormal cardiac mechanics. Cardiovasc Ultrasound. 2014 Oct 3;12:40.
Journal cover image

Published In

Cardiovasc Ultrasound

DOI

EISSN

1476-7120

Publication Date

October 3, 2014

Volume

12

Start / End Page

40

Location

England

Related Subject Headings

  • Ventricular Dysfunction, Left
  • United States
  • Stress, Mechanical
  • Sensitivity and Specificity
  • Risk Factors
  • Reproducibility of Results
  • Prevalence
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted