title: Direct ultrasound measurement of longitudinal, circumferential, and radial strain using 2-dimensional strain imaging in normal adults.
abstract: Current noninvasive techniques used to evaluate left ventricular systolic function are limited by dependence on the angle of insonation (tissue Doppler imaging/TDI) or limited by availability (MRI tagging). We utilized 2-dimensional speckle strain (epsilon) imaging (1) to establish normal values for all three epsilon vectors; (2) to compare circumferential epsilon values with circumferential shortening (midwall fractional shortening (FS(mw)); (3) to examine the relationship between left ventricular epsilon and wall stress; and (4) to compare 2D echocardiographic characteristics by gender. Echocardiography was performed in 60 normal subjects (mean 39 +/- 15 years). Small, but significant regional heterogeneity was seen in circumferential epsilon, but not in radial or longitudinal epsilon. We found an inverse correlation between circumferential epsilon and stress (r =-0.29, p<0.05) as well as longitudinal epsilon and stress (r =-0.11, P < 0.05), though the relationships were not close. We also observed a linear relationship between mean circumferential epsilon and FS(mw) (r = 0.29, P < 0.05). In conclusion, (1) 2-dimensional epsilon imaging permits measurement of regional systolic epsilon values in the majority of normal individuals; (2) epsilon values furnished by this method obey expected stress-shortening relationships; (3) systolic epsilon displays minor regional heterogeneity in the circumferential direction; (4) for the first time, a close relationship between FS(mw) and mean circumferential epsilon was demonstrated; and (5) there are minor gender-related differences in LV geometry and function.
authors.affiliation: Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01606, USA.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Hurlburt
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Aurigemma
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Hill
authors.forename: Arumugam
authors.initials: A
authors.lastname: Narayanan
authors.forename: William H
authors.initials: WH
authors.lastname: Gaasch
authors.forename: Craig S
authors.initials: CS
authors.lastname: Vinch
authors.forename: Theo E
authors.initials: TE
authors.lastname: Meyer
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Tighe
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016276:Ventricular Function; D016277:Ventricular Function, Left / Q000502:physiology*