title: Myocardial deformation by speckle tracking in severe dilated cardiomyopathy.
abstract: BACKGROUND
  The high and increasing prevalence of Dilated Cardiomyopathy (DCM) represents a serious public health problem. New technologies are being used aiming at more accurate diagnoses in order to improve therapeutic approach. In this scenario, speckle tracking echocardiography (STE) uses natural myocardial markers to analyze the systolic deformation of the left ventricle (LV).
  
  
  OBJECTIVE
  To measure the longitudinal transmural global strain (GS) of the LV through STE in patients with severe DCM, comparing the results with normal individuals and with echocardiographic parameters established for the analysis of LV systolic function, validating the method in this population.
  
  
  METHODS
  We studied 71 patients with severe DCM (53 ± 12 years, 72% men) and 20 controls (30 ± 8 years, 45% men). We obtained LV volumes and ejection fraction by two and three-dimensional echocardiography, Doppler parameters, tissue Doppler and GS was obtained by STE.
  
  
  RESULTS
  Compared to controls, LV volumes were higher in the DCM group; however, LVEF and peak velocity of E wave were lower in the latter. The myocardial performance index was higher among patients. Myocardial velocities at the tissue Doppler (S', e', a') were significantly lower and E/e' ratio was higher in the DCM group. The GS was decreased in the DCM group (-5.5% ± 2.3%) when compared to controls (-14.0% ± 1.8%).
  
  
  CONCLUSIONS
  In this study, GS was significantly lower in patients with severe DCM, bringing new perspectives for therapeutic approaches in this specific population.
authors.affiliation: Insitituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. cristinaabduch@cardiol.br
authors.forename: Maria Cristina Donadio
authors.initials: MC
authors.lastname: Abduch
authors.forename: Ivan
authors.initials: I
authors.lastname: Salgo
authors.forename: Wendy
authors.initials: W
authors.lastname: Tsang
authors.forename: Marcelo Luiz Campos
authors.initials: ML
authors.lastname: Vieira
authors.forename: Victoria
authors.initials: V
authors.lastname: Cruz
authors.forename: Marta
authors.initials: M
authors.lastname: Lima
authors.forename: Jeane Mike
authors.initials: JM
authors.lastname: Tsutsui
authors.forename: Victor
authors.initials: V
authors.lastname: Mor-Avi
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lang
authors.forename: Wilson
authors.initials: W
authors.lastname: Mathias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D055815:Young Adult