Analysis of the interaction between segmental relaxation patterns and global diastolic function by strain echocardiography.
BACKGROUND
Strain echocardiography can depict segmental mechanical activity with high temporal and spatial accuracy, and may allow assessment of segmental relaxation not possible with conventional echocardiography.


METHODS
Conventional and strain echocardiography were performed in healthy volunteers (young [group 1] and old [group 2]) and patients with normal 2-dimensional and stress echocardiography, with either normal global diastolic function (group 3a) or grade I or II global diastolic dysfunction (DD) (group 3b). Standard echocardiography criteria were used to define global DD. Early to late diastolic strain rate ratio less than 1.1 was defined as altered segmental relaxation.


RESULTS
All participants had normal wall motion and ejection fraction. Participants of group 1 had normal segmental and global diastolic function. Participants of groups 2 and 3a demonstrated a wide range of altered segmental relaxation in the absence of global DD. All patients of group 3b had 12 or more segments with altered relaxation and global DD. Age and hypertension were associated with a larger number of altered segments, a lower mean early to late diastolic strain rate ratio, and global DD.


CONCLUSIONS
A wide range of altered segmental relaxation can exist in the absence of global DD. Age and hypertension are associated with altered segmental relaxation and global DD. Assessment of segmental relaxation may be beneficial in the elderly and patients with hypertension.
Takemoto
Yasuhiko
Y
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Pellikka
Patricia A
PA
Wang
Jianwen
J
Modesto
Karen M
KM
Cauduro
Sanderson
S
Belohlavek
Marek
M
Seward
James B
JB
Thomson
Helen L
HL
Khandheria
Bijoy
B
Abraham
Theodore P
TP
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004548:Elasticity; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D013223:Statistics as Topic; D013314:Stress, Mechanical; D013599:Systole; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*