title: Time-Dependent Regional Myocardial Strains in Patients with Heart Failure with a Preserved Ejection Fraction.
abstract: OBJECTIVE
  To better understand the etiology of HFpEF in a controlled human population, regional time-varying strains were computed using echocardiography speckle tracking in patients with heart failure with a preserved ejection fraction and normal subjects.
  
  
  METHODS
  Eleven normal volunteers and ten patients with echo-graded diastolic dysfunction and symptoms of heart failure were imaged with echocardiography and longitudinal, circumferential, and rotational strains were determined using speckle-tracking. Diastolic strain rate was also determined. Patient demographics and echo-derived flows, volumes, and pressures were recorded.
  
  
  RESULTS
  Peak longitudinal and circumferential strain was globally reduced in patients (p < 0.001), when compared to controls. The patients attained peak longitudinal and circumferential strain at a consistently later point in systole than controls. Rotational strains were not different in most LV regions. Early diastolic strain rate was significantly reduced in the patients (p < 0.001). LV mass and wall thickness were significantly increased in the patients; however ejection fraction was preserved and stroke volume was diminished (p < 0.001).
  
  
  CONCLUSIONS
  This study shows that patients with HFpEF have reduced early diastolic strain rate and reduced peak strain that is regionally homogeneous and that they also utilize a longer fraction of systole to achieve peak axial strains.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA.
authors.forename: Shane P
authors.initials: SP
authors.lastname: Smith
authors.affiliation: Department of Physiology, University of Arizona, Tucson, AZ 85724, USA; Program in Applied Mathematics, University of Arizona, Tucson, AZ 85721, USA.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Secomb
authors.affiliation: Program in Applied Mathematics, University of Arizona, Tucson, AZ 85721, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Hong
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Moulton
mesh_terms: D000328:Adult; D000368:Aged; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology