European Journal of Echocardiography Advance Access published online on April 9, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jep037
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Interpretation of two-dimensional and tissue Doppler-derived strain (
) and strain rate data: is there a need to normalize for individual variability in left ventricular morphology?
1 Faculty of Medicine and Health, School of Healthcare, University of Leeds, Leeds LS2 9UT, UK
2 Health and Social Care Institute, University of Teesside, Middlesbrough, UK
3 Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK
4 Faculty of Biological Sciences, University of Leeds, Leeds, UK
5 Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
6 Department of Physiology, University of Otago, Dunedin, New Zealand
Received 15 January 2009; accepted after revision 22 March 2009.
* Corresponding author. Tel: +44 1133437962, Fax: +44 1133431204. E-mail address: d.oxborough{at}leeds.ac.uk
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Abstract |
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Aims: This study examined the relationships between myocardial strain (
) and strain rate (SR) data, derived from both two-dimensional (2D) speckle tracking and tissue Doppler imaging (TDI), and indices of left ventricular (LV) morphology to assess size-(in)dependence of these functional parameters.
Methods and results: 2D speckle tracking and TDI echocardiograms were performed in 79 healthy adult male volunteers (age range: 22–76 years). 2D speckle tracking allowed the determination of myocardial and peak systolic and early diastolic SR in radial, circumferential, and longitudinal planes, whereas TDI provided longitudinal only. Mean circumferential and radial and SR were calculated from data collected at six basal myocardial regions, whereas mean longitudinal and SR derived from both 2D speckle tracking and TDI were calculated from the basal septum and basal lateral walls. Standard 2D echocardiography allowed the assessment of LV morphology including LV length, LV end-diastolic volume, LV end-diastolic diameter, mean wall thickness, and LV mass. The association of myocardial and SR data with relevant LV morphology indices was determined by adoption of the general, non-linear allometric model (y= axb). The b exponent ±95% confidence intervals were reported. The relationships between the measures of LV morphology and myocardial and SR were highly variable and generally weak. Only two relationships displayed at least a moderate effect size (r 
0.30): (i) 2D circumferential peak systolic SR and LV end-diastolic dimension (b = –0.92; –1.35 to 0.5, r = 0.44) and (ii) TDI longitudinal peak systolic SR and LV length (b = –1.39; –2.11 to –0.66, r = 0.41).
Conclusion: The empirical relationships derived in this cohort do not support the need to scale myocardial and SR derived from 2D speckle or TDI for any index of LV morphology.
Keywords: Speckle tracking; Tissue Doppler; Left ventricle; Scaling; Allometry
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