title: Left and right ventricular strain and strain rate measurement in normal adults using velocity vector imaging: an assessment of reference values and intersystem agreement.
abstract: Velocity vector imaging (VVI) software permits quantitative assessment of ventricular function through measurement of myocardial strain (S) and strain rate (SR). The purpose of this study was to define a reference range of ventricular S and SR values in normal adults using VVI software, and to describe the variability among observers and systems. Two-dimensional echocardiography was performed in 186 healthy adults free of cardiovascular disease or risk factors, followed by comprehensive ventricular S and SR analysis using VVI software. Images were acquired using three commercial ultrasound systems. The mean age of patients was 44 ± 16 years, and 114 (61 %) were female. Mean global left ventricular (LV) longitudinal, circumferential, and radial S and SR, and right ventricular (RV) longitudinal S and SR values are presented. Significant segmental variation in regional LV and RV S and SR was detected. Multivariate regression analysis demonstrated global longitudinal LV (p = 0.05) and RV (p = 0.002) S values decline significantly with age. The overall variability of S and SR values accounted for by patient demographic and hemodynamic variables was low (16 and 8 % for LV longitudinal S and SR, respectively). Interobserver agreement was very good, but was lowest for LV radial S and SR. There were no significant differences of LV and RV S and SR between ultrasound systems. Comprehensive reference values for the normal ranges of LV and RV S and SR measured using VVI software are presented. The ultrasound system used for image acquisition did not significantly influence results.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Nowell M
authors.initials: NM
authors.lastname: Fine
authors.forename: Aijaz A
authors.initials: AA
authors.lastname: Shah
authors.forename: Il-Yong
authors.initials: IY
authors.lastname: Han
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Ju-Feng
authors.initials: JF
authors.lastname: Hsiao
authors.forename: Yuki
authors.initials: Y
authors.lastname: Koshino
authors.forename: Hayder K
authors.initials: HK
authors.lastname: Saleh
authors.forename: Fletcher A
authors.initials: FA
authors.lastname: Miller
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pellikka
authors.forename: Hector R
authors.initials: HR
authors.lastname: Villarraga
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods* / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012984:Software; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right