LEFT VENTRICULAR STRAIN: SEX- AND AGE-RELATED CHARACTERISTICS AND ASSOCIATIONS WITH CARDIOVASCULAR DISEASES (REVIEW OF LITERATURE)
V.P. Guseva1, S.K. Malyutina1,2, A.N. Ryabikov1,2, E.V. Voronina1, E.V. Shubkina1, A.I. Sinyova2
1Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
2Novosibirsk State Medical University, 630091, Novosibirsk, Krasny av., 52
Keywords: myocardial strain, strain rate, speckle tracking imaging, risk factors, cardiovascular disease, prognosis
Abstract
The standard indicators of function of the left ventricle (LV) (ejection fraction, end-diastolic and end-systolic volumes, of local contractility) depend on the circulation load and partly are subjective. The indices of myocardial deformation allow to objectify the assessment of left ventricular function and to detect changes even in subclinical myocardial lesion. Objectives. This review analyzes the literature data focused on the ultrasound assessment of myocardial deformation (Strain) in various cardiovascular diseases (CVD), published during the last 15 years (2001-2016) using PubMed ( https://www.ncbi.nlm.nih.gov/pubmed) and Google Scholar ( https://scholar.google.ru). Results. The deformation of LV myocardium, as a 3D object, is considered as a longitudinal, circular and radial Strain. According to data obtained, the indicators of myocardial Strain are related to age and sex (in men lower than in women, decreased with aging), they have diagnostic significance for myocardial infarction, acute and chronic heart failure (HF), cardiomyopathy, Strain characteristics in hypertension and subclinical myocardial damage are investigated less. Not numerous clinical studies have demonstrated predictive value of Strain in respect to CVD complications and outcomes. Very few studies available are available in population, they revealed the association between LV Strain with the risk of acute coronary events, malignant arrhythmias, HF, death from CVD and from all causes (risk coefficients were around 1.3 for CHD, 1.7 for HF and 1.6-2.0 for fatal CVD and total mortality). Conclusion. Strain technology is perspective. Currently, the age- and sex- specific reference values of Strain are still under the question; further studies of LV Strain are warranted for assessment of early systolic dysfunction and investigation of association with CVD risk factors and prognosis. |
