title: Normal left ventricular mechanics by two-dimensional speckle-tracking echocardiography. Reference values in healthy adults.
abstract: OBJECTIVE
  Two-dimensional speckle-tracking echocardiography is a novel tool to assess myocardial function. The purpose of this study was to evaluate left ventricular myocardial strain and rotation parameters by two-dimensional speckle-tracking echocardiography in a large group of healthy adults across a wide age range to establish their reference values and to assess the influence of age, sex, and hemodynamic factors.
  
  
  METHODS
  Transthoracic echocardiograms were acquired in 247 healthy volunteers (139 women, 44 years [standard deviation, 16 years old] (range, 18-80 years). We measured longitudinal, circumferential, and radial peak systolic strain values, and left ventricular rotation and twist.
  
  
  RESULTS
  Average values of global longitudinal, radial, and circumferential strain were -21.5% (standard deviation, 2.0%), 40.1% (standard deviation, 11.8%) and -22.2% (standard deviation, 3.4%), respectively. Longitudinal strain was significantly more negative in women, whereas radial and circumferential strain and rotational parameters were similar in both sexes. Accordingly, lower limits of normality for the strain components were -16.9% in men and -18.5% in women for longitudinal strain, and -15.4% for circumferential and 24.6% for radial strain, irrespective of sex. Longitudinal strain values were more negative at the base than at apical segments. Mean rotational values were -6.9° (standard deviation, 3.5°) for the base, 13.0° (standard deviation, 6.5°) for apical rotation, and 20.0° (standard deviation, 7.3°) for net twist.
  
  
  CONCLUSIONS
  We report the comprehensive assessment of normal myocardial deformation and rotational mechanics in a large cohort of healthy volunteers. We found that women have more negative longitudinal strain, accounting for their higher left ventricular ejection fraction. Availability of reference values for these parameters may foster their implementation in the clinical routine.
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Gonenc
authors.initials: G
authors.lastname: Kocabay
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Denisa
authors.initials: D
authors.lastname: Muraru
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Diletta
authors.initials: D
authors.lastname: Peluso
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Cucchini
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Sorina
authors.initials: S
authors.lastname: Mihaila
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Seena
authors.initials: S
authors.lastname: Padayattil-Jose
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Denas
authors.initials: D
authors.lastname: Gentian
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova School of Medicine, Padua, Italy. Electronic address: lpbadano@gmail.com.
authors.forename: Luigi P
authors.initials: LP
authors.lastname: Badano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000379:methods*; D005260:Female; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: Deformación miocárdica; Ecocardiografía speckle tracking; Giro; Healthy participants; Individuos normales; Individuos sanos; Left ventricle; Myocardial deformation; Normal participants; Reference values; Speckle-tracking echocardiography; Strain bidimensional; Twist; Two-dimensional strain; Valores de referencia; Ventrículo izquierdo