title: Multidirectional global left ventricular systolic function in normal subjects and patients with hypertension: multicenter evaluation.
abstract: BACKGROUND
  The aim of this multicenter study was to determine the normal ranges and the clinical relevance of multidirectional systolic parameters to evaluate global left ventricular (LV) systolic function.
  
  
  METHODS
  Three hundred twenty-three healthy adult subjects prospectively included at 10 centers and a cohort of 310 patients with hypertension were analyzed. Multidirectional global LV systolic function was analyzed using two-dimensional speckle-tracking echocardiography by means of two indices: longitudinal-circumferential systolic index (the average of longitudinal and circumferential global systolic strain) and global systolic index (the average of longitudinal, circumferential, and radial global systolic strain).
  
  
  RESULTS
  The ranges of values of the multidirectional systolic parameters in healthy subjects were -21.22 ± 2.22% for longitudinal-circumferential systolic index and 29.71 ± 5.28% for global systolic index. In addition, the lowest expected values of these multidirectional indices were determined in this population (calculated as -1.96 SDs from the mean): -16.86% for longitudinal-circumferential systolic index and 19.36% for global systolic index. Concerning the clinical relevance of these measurements, these indices indicated the presence of subtle LV global systolic dysfunction in patients with hypertension, even though LV global longitudinal systolic strain and LV ejection fraction were normal. Moreover, in these patients, functional class (dyspnea [New York Heart Association classification]) was inversely related to both the longitudinal-circumferential index and the global systolic index.
  
  
  CONCLUSIONS
  In the present multicenter study analyzing a large cohort of healthy subjects and patients with hypertension, the normal range and the clinical relevance of multidirectional systolic parameters to evaluate global LV systolic function have been determined.
authors.affiliation: Charité University Hospital, Berlin, Germany. Electronic address: daniel-armando.morris@charite.de.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Morris
authors.affiliation: University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Otani
authors.affiliation: Charité University Hospital, Berlin, Germany.
authors.forename: Tarek
authors.initials: T
authors.lastname: Bekfani
authors.affiliation: Nagano Children's Hospital, Azumino, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Takigiku
authors.affiliation: Tenri Hospital, Tenri, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Izumi
authors.affiliation: Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yuda
authors.affiliation: Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Konomi
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohte
authors.affiliation: Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.affiliation: Charité University Hospital, Berlin, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Friedrich
authors.affiliation: Charité University Hospital, Berlin, Germany.
authors.forename: York
authors.initials: Y
authors.lastname: Kühnle
authors.affiliation: Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakatani
authors.affiliation: University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
authors.affiliation: Charité University Hospital, Berlin, Germany.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.affiliation: Charité University Hospital, Berlin, Germany.
authors.forename: Leif-Hendrik
authors.initials: LH
authors.lastname: Boldt
authors.affiliation: University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeuchi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D004452:Echocardiography / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods; D006352:Heart Ventricles / Q000503:physiopathology; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D007564:Japan; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Left ventricular; Speckle-tracking echocardiography; Strain; Systolic function