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European Journal of Echocardiography Advance Access published online on September 30, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen230
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Left ventricular size determines tissue Doppler-derived longitudinal strain and strain rate

Assami Rösner1,2,*, Bart Bijnens3,4, Magna Hansen1,2, Ole Jakob How1,2, Erling Aarsæther1,2, Stig Müller1,2, George R. Sutherland5 and Truls Myrmel1,2

1 Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
2 University Hospital North Norway, Tromsø, Norway
3 Imaging and Cardiovascular Dynamics, KULeuven, Leuven, Belgium
4 Center for Computational Imaging and Simulation Technologies in Biomedicine, Universitat Pompeu Fabra, Barcelona, Spain
5 St George's Hospital, London, UK

Received 15 May 2008; accepted after revision 8 August 2008.

* Corresponding author. Tel: +47 95990071; fax: +47 77628298. E-mail address: assami.rosner{at}unn.no


  Abstract

Aims: Tissue Doppler-derived indices of strain ({epsilon}) and strain rate (SR) have been developed to assess regional cardiac function. However, the effect of left ventricular (LV) size on {epsilon} and SR has not been studied in depth. The aim of this study was to assess to what extent heart size influence {epsilon} or SR.

Methods and results: In 21 anaesthetized pigs ranging from 12.5 to 70.0 kg, tissue Doppler-derived {epsilon} and SR, and haemodynamic parameters, were assessed during controlled heart rates and different loading conditions. dP/dt did not correlate to pig weight, suggesting constant contractility during growth. Longitudinal {epsilon} and SR were significantly higher in smaller compared with larger hearts. The hyperbolic correlation between pigs weight and {epsilon} and SR was r2 = 0.621 and 0.372, respectively, both P < 0.0001. Afterload elevation induced a reduction in longitudinal {epsilon} (from –24.2 ± 3.2 to –12.1 ± 5.5%, P = 0.001) and SR (from –2.3 ± 0.8 to –1.3 ± 2.4 s–1, P = 0.034), whereas increasing preload increased {epsilon} (from –26.4 ± 10.3 to –38.1 ± 14.3%, P = 0.006) and SR (from –2.3 ± 0.9 to –4.22 ± 1.8 s–1, P = 0.002).

Conclusion: Longitudinal {epsilon} and SR decrease with increasing LV dimensions in spite of an unaltered contractility. These results show and confirm that heart size influences {epsilon} and SR, which are highly load-dependent parameters.

Keywords: Left ventricular function; Strain and strain rate; Haemodynamic; Tissue Doppler imaging; Cardiac size; Loading conditions


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