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Left and right ventricular strain and strain rate measurement in normal adults using velocity vector imaging: an assessment of reference values and intersystem agreement

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Abstract

Velocity vector imaging (VVI) software permits quantitative assessment of ventricular function through measurement of myocardial strain (S) and strain rate (SR). The purpose of this study was to define a reference range of ventricular S and SR values in normal adults using VVI software, and to describe the variability among observers and systems. Two-dimensional echocardiography was performed in 186 healthy adults free of cardiovascular disease or risk factors, followed by comprehensive ventricular S and SR analysis using VVI software. Images were acquired using three commercial ultrasound systems. The mean age of patients was 44 ± 16 years, and 114 (61 %) were female. Mean global left ventricular (LV) longitudinal, circumferential, and radial S and SR, and right ventricular (RV) longitudinal S and SR values are presented. Significant segmental variation in regional LV and RV S and SR was detected. Multivariate regression analysis demonstrated global longitudinal LV (p = 0.05) and RV (p = 0.002) S values decline significantly with age. The overall variability of S and SR values accounted for by patient demographic and hemodynamic variables was low (16 and 8 % for LV longitudinal S and SR, respectively). Interobserver agreement was very good, but was lowest for LV radial S and SR. There were no significant differences of LV and RV S and SR between ultrasound systems. Comprehensive reference values for the normal ranges of LV and RV S and SR measured using VVI software are presented. The ultrasound system used for image acquisition did not significantly influence results.

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Abbreviations

2D:

2-Dimensional

BMI:

Body mass index

CI:

Confidence interval

DICOM:

Digital Imaging and Communications in Medicine

EF:

Ejection fraction

ICC:

Intraclass correlation coefficient

LV:

Left ventricle

MRI:

Magnetic resonance imaging

RV:

Right ventricle

S:

Strain

SD:

Standard deviation

SEM:

Standard error of the mean

SR:

Strain rate

STE:

Speckle-tracking echocardiography

TDI:

Tissue Doppler imaging

TTE:

Transthoracic echocardiography

VVI:

Velocity vector imaging

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Authors and Affiliations

  1. Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Nowell M. Fine, Aijaz A. Shah, Il-Yong Han, Yang Yu, Ju-feng Hsiao, Yuki Koshino, Hayder K. Saleh, Fletcher A. Miller Jr., Jae K. Oh, Patricia A. Pellikka & Hector R. Villarraga

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  1. Nowell M. Fine
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  2. Aijaz A. Shah
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Correspondence to Hector R. Villarraga.

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Fine, N.M., Shah, A.A., Han, IY. et al. Left and right ventricular strain and strain rate measurement in normal adults using velocity vector imaging: an assessment of reference values and intersystem agreement. Int J Cardiovasc Imaging 29, 571–580 (2013). https://doi.org/10.1007/s10554-012-0120-7

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  • DOI: https://doi.org/10.1007/s10554-012-0120-7

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