Noninvasive quantification of regional myocardial function using Doppler-derived velocity, displacement, strain rate, and strain in healthy volunteers: effects of aging

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Abstract

Quantification of regional function can be performed using Doppler tissue echocardiography to evaluate myocardial velocity, tissue displacement, strain, and strain rate. Although these techniques have been validated in animal experiments and early clinical trials, there are only limited measurements in healthy populations to use as reference data. In 100 healthy volunteers, left ventricular myocardial velocity, displacement, strain, and strain rate were measured using Doppler tissue echocardiography. Measurements were obtained from basal, mid, and apical segments of walls visualized from left ventricular apical 4- and 2-chamber views. Analysis of covariance was used to examine the effects of age and wall segment position. All parameters showed a strong dependence on wall segment position. Although myocardial velocities and strain rate showed significant dependence on age, displacement and peak systolic strain measures were less affected. Like pulsed Doppler mitral inflow velocity, tissue velocity and strain rate show age-related changes.

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Population

The institutional review board on human research approved this study, and all participants gave informed consent. Healthy volunteers free of any known cardiovascular disease between the ages of 18 and 76 years were recruited. All volunteers underwent a thorough history, physical examination, and had a normal electrocardiogram. None of them reported taking any kind of cardioactive medications (except aspirin).

Echocardiographic study

A complete echocardiographic study was performed on all participants using an

Results

In all, 100 healthy volunteers were recruited. The mean age was 43 ± 15 years (range: 18-76 years) and 52 (52%) were men. There were 22 (21.5%) participants between 18 and 29 years old, 23 (22.5%) between 30 and 39 years, 26 (26%) between 40 and 49 years, 14 (14%) between 50 and 59 years, and 15 (15%) above 60 years. Their resting heart rates varied between 44 and 86 bpm (mean 66 ± 11 bpm), and their blood pressure varied from 80 to 120/60 to 80 mm Hg (mean 110 ± 10/70 ± 10 mm Hg).

Discussion

In this study, we report normal age-adjusted values for systolic tissue velocity, displacement, strain rate, and strain as measured by DTE. Differences in acquired data between the segments of individual walls are demonstrated, as are gradual changes in these values with age. Reproducibility of these measurements and the agreement of the measurements between 2 readers were acceptable, indicating that these techniques can be implemented into the clinical practice.

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