Normal Value Ranges of LV Deformation, Rotation and Twist Parameters in Healthy Adults by 4Dimensional XStrain Speckle Tracking Echocardiography

Download Article

DOI: 10.21522/TIJAR.2014.09.02.Art009

Authors : Akhil Mehrotra, Mohammad Shadab, Naveen Chandra, Shubham Kacker, Alok Kumar Singh

Abstract:

XStrain 4D Speckle tracking echocardiography is a novel approach to address both the strain deformation and rotational mechanics of LV. The aim was to comprehensively present the normal value ranges of LV strain and rotational parameters of healthy Indian adults after assessment with this innovative technique. The study population comprising of 80 adults (58 males, 22 females; Group A < 30 years, Group B > 31 years) is revealing the values of Global longitudinal strain (GLS), Global longitudinal strain rate (GLSR), Transverse strain (TS), Transverse strain rate (TSR), Shear and Shear rate are greater in men than in women (p<0.01) and moreover in Group A, Global Circumferential strain (GCS), Global Circumferential strain rate (GCSR), Global Radial strain and Global Radial strain rate (GRSR) were similarly higher in men. Peak apical rotation, peak twist, twist rate and untwist rate values were again greater in men (p<0.01) and increased with advancing age. This is the first study to present a candid and comprehensive analysis of extensive parameters of LV strain and rotational mechanics in healthy Indian adults.

Keywords: 4Dimensional XStrain echocardiography, LV rotational mechanics, LV twist and torsion, Speckle tracking echocardiography

References:

[1] Yingchoncharoen T, Agarwal S, Popovic ZB. Normal ranges of left ventricular strain: a meta-analysis. J Am Soc Echocardiogr. 2013; 26:185-91.

[2] Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr, 2015; 28:1- 39.e14.

[3] Jasaityte R, Heyde B, D’Hooge J. Current state of three-dimensional myocardial strain estimation using echocardiography. J Am Soc Echocardiogr.2012; 26:15-28.

[4] Papademetris X, Sinusad AJ, Dione DP, et al. Estimation of 3D left ventricular deformation from echocardiography. Med Image Anal. 2001; 15:17-28.

[5] Elen A, Choi HF, Loeckx D, et al. Three-dimensional cardiac strain estimation using spatio-temporal elastic registration of ultrasound images: a feasibility study. IEEE Trans Med Imaging. 2008; 27:1580-91.

[6] Lower R. Tractatus de Corde, London, UK: Oxford University Press, 1669.

[7] Kaku K, Takeuchi M, Tsang W, Takigiku K, Yasukochi S, Patel AR, Mor Avi V, Lang RM, Otsuji Y. Age-related normal range of left ventricular strain and torsion using three-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr. 2014; 27:55-64. doi: 10.1016/j. echo.2013.10.002.

[8] Takahashi K, Al Naami G. Thompson R, Inage A, Mackie AS, Smallhorn JF. Normal rotational, torsion and untwisting data in children, adolescents, and young adults. J Am Soc Echocardiogr. 2010; 23:286-293. doi: 10.1016/j.echo.2009.11.018.

[9] A. D’ Andrea, A. Stanziola, E. Di palma, M. Martino, M. D’ Alto, S. Dellegrottaglie. Right Ventricular structure and function in idiopathic pulmonary fibrosis with or without pulmonary hypertension Echocardiography 33 (1) (Jun 11, 2015) 57-65.

[10] Georgette E. Hoogslag, Marlieke L.A. Haeck, Matthijs A. Velders, Emer Joyce, Helen Boden, Martin J. Schalij, Jeroen J. Bax, Nina Ajmone Marsan,Victoria Delgado,Determinants of Right Ventricular Remodeling Following ST-Segment Elevation Myocardial Infarction, American Journal of Cardiology, 2014;114(10);1490-1496.

[11] Hematian M, Torabi S, Malakan-Rad E, Sayadpour-Zanjani K, Ziaee V. Noninvasive Evaluation of Myocardial Systolic Dysfunction in the Early Stage of Kawasaki Disease: A Speckle- Tracking Echocardiography Study. Iran J Pediatr. 2015;25(3).

[12] D’Andrea A, Mele D, Agricola E. XStrain 4D analysis predicts left ventricular remodeling in patients with recent non-ST-segment elevation myocardial infraction. Int J Cardiol. 2016; 206: 107- 109.

[13] Muraru, D.; Niero, A.; Zanella, H.R.; Cherata, D.; Badano, L.P. Three-dimensional speckle-tracking echocardiography: Benefits and limitations of integrating myocardial mechanics with three- dimensional imaging. Cardiovasc. Diagn, Ther, 2018, 8,101-117.

[14] Corda, Andrea & Pinna Parpaglia, Maria Luisa & Sotgiu, Giovanni & Zobba, Rosanna & Ochoa,Pablo & Ramos, Jorge & French, Anne. Use of 2-dimensional speckle-tracking Echocardiography in dogs with systemic inflammatory response syndrome. Journal of Veterinary Internal Medicine, 2019; 33(10).

[15] Arts T, Meerabum S, Reneman RS, Corday E. Torsion of the left ventricle during the ejection phase in the intact dog. Cardiovasc Res. 1984; 18:183-93.

[16] Van mil AC, Drane A, Pearson J, McDonnell B, Cockcroft JR, Stöhr EJ. Interaction of LV twist with arterial haemodynamics during localised. Exp Physiol. 2016; 101:509-20.

[17] Stöhr EJ, Shave RE, Baggish AL, Weiner RB. Left ventricular twist mechanics in the context of normal physiology and cardiovascular disease: a revies of studies using speckle tracking echocardiography. Am J Physiol Heart Circ Physiol. 2016; 311:H633-44.

[18] Carreras F, Garcia-Barnes J, Gil D, Pujadas S, Li Chi H, Suarez-Arias R, left ventricular torsion and longitudinal shortening: two fundament components of myocardial mechanics assessed by tagged cine-MRI normal subjects. Int J Cardiovasc Imaging. 2012; 28: 273-84.

[19] Takahashi K, Al Naami G, Thompson R, Inage A, Mackie AS, Smallhorn JF, Normal rotational, torsion and untwisting data in children, adoledcents and young adults. J Am Soc Echocardiogr. 2010; 23:286-93.

[20] Reckefuss N, Butz T, Horstkotte D, Faber L. Evaluation of longitudinal and radial left ventricular function by two-dimensional speckle-tracking echocardiogra-phy in a large cohort of normal probands. Int J Cardiovasc Imaging. 2011; 27:515-26.

[21] Marwick TH, Leano RL, Brown J. Sun JP. Hoffmann R, Lysyansky P, Myocardial strain measurements with 2-dimensional speckle-tracking echocardiography: definition of normal range. JACC Cardiovasc Imaging. 2009; 2:80-4.

[22] Hurlburt HM, Aurigemma GP, Hill JC, Narayanan A, Gaasch WH, Vinch CS, Direct ultrasound measurement of longitudinal, circumferential, and radial strain using 2-dimensional strain imaging in normal adults. Echocardiography. 2007; 24:723-31.

[23] Friedewald WT, Levy RI, Fredrickson Estimation of the concentration of densitylipoprotein in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18:499-502.

[24] Lang, R. M., Bierig, M., Devereux, R. B., (2005) Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Chamber Quantification Writing Group. Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18, 1440-1463.

[25] Devereux, R. B., Alonso, D.R., Lutas, E. M., Gottlieb, G.J., Campo, E., Sachs, I., (1986) Echocardiographic Assessment of Left Ventricular Hypertrophy. Comparison to Necropsy Findings. American Journal of Cardiology, 57,450-458.

[26] Sengupta, P.P., Tajik, A. J., Chandrasekaran, K. and Khandheria, B. K. (2008) Twist Mechanics of the Left Ventricle: Principles and Application. JACC. Cariovascular Imaging. 1, 366-376.

[27] Mondillo subjects, Galderisi M, Mele D, Cameli M, Lomoriello VS, Zaca V, Echocardiography study group of the Italian society of C. Speckle tracking echocardiography: a new technique for assessing myocardial function. J. Ultrasound Med. 2011; 30:71-83.

[28] Cameli M, Mondillo S, Solari M, Righini FM, Andrei V, Contaldi C, Echocardiographic assessment of left ventricular systolic function from ejection fraction to torsion. Heart Fail Rev. 2016; 21:77-94.

[29] Torrent-Guasp F, Buckberg GD, Clemente C, Cox JL, Coghlan HC, Gharib M. The structure and function of the helical heart and its buttress wrapping. I. The normal macroscopic structure of the heart. Semin Thorac Cardiovasc Surg. 2001; 13(4):301-19.

[30] Torrent-Guasp F, Kocica MJ, Corno AF, Komeda M, Carreras- Costa F, Flotats A. Towards new understanding of the heart structure and function. Eur J Cardiothorac Surg. 2005; 27(2):191-201.

[31] Arts T, Reneman RS, Veenstra PC. A model of the mechanics of the left ventricle. Ann Biomed Eng. 1979; 7(3-4):299-318.

[32] Cutrl E, Serrani M, Bagnoli P, Fumero R, Costantino ML. The cardiac torsion as a sensitive index of heart pathology: a model study. J mech Behav Biomed Mater. 2010; 55:104-19.

[33] Torrent Guasp F. Sobre morfologia y funcionalismo cardiacos (partes I, II y III). Rev ESP Cardiol 1966; 19:48-55. 56-71, 72-82

[34] Moon MR, Ingels NB Jr, Daughters GT, Stinson EB, Hansen DE, Miller DC. Alterations in left ventricular twist mechanics with inotropic simulation and volume loading in human subjects Circulation 1994; 89:142-50.

[35] Wang J, Khoury DS, Yue Y, Torre-Aminoe G, Nagueh SF. Preserved left ventricular twist and circumferential deformation, but depressed longitudinal and radial deformation in patients with diastolic heart failure Eur Heart J. 2008;29:1283-9.

[36] Marcelli E, Cercenelli L, Musaico M, Bagnoli P, Costantino ML, Fumero R, Plicchi G. Assessment of cardiac rotation by means of gyroscopic sensors. In: Comput Cardiol. 2008; 35:389-92.

[37] Esch BT, Warburton DER. Left ventricular torsion and recoil: implications for exercise performance and cardiovascular disease J Appl Physiol. 2009; 106(2):362-9.

[38] Cutrl E, Bagnoli P, Marcelli E, Biondi F, Cercenelli L, Costantino ML. A mechanical simulator of cardiac wall kinematics ASAIO J. 2010; 56(3):164-71.

[39] Kraigher-Krainer E, shah AM, Gupta DK, Santos A, Claggett B, Pieske B. Impaired systolic function by strain imaging in heart failure with preserved ejection fraction. J Am Coll Cardiol 2014; 63; 447-56.

[40] Komajda M, Lam CS. Heart failure with preserved ejection fraction a clinical dilemma. Eur Heart J. 2014; 35:1022-32.

[41] Tribouiiloy C, Rusinaru D, Mahjoub H, Goissen T, Levy F, Peltier M. Impact of echocardiography in patients hospitalized for heart failure a prospective observational study. Arch Cardiovasc Dis. 2008; 101:465-73.

[42] Hasselberg NE, Haugaa KH, Sarvari SI, Gullestad L, Andreassen AK, Smiseth OA, Edvardsen T. Left ventricular global longitudinal strain is associated with exercise capacity in failure hearts with preserved and reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2015; 16:217-24.

[43] Stampehl MR, Mann DL, Nguyen JS, Cota F, Colmenares C, Dokanish H. Speckle Strain echocardiography predicts outcome in patients with heart failure with both depressed and preserved left ventricular ejection fraction. Echocardiography. 2015:32:71-8.

[44] Kuznetsova, L. Herbots, T. Richart, J. D’hooge, L. Thijs, R.H. Fagard. Left ventricular strain and strain rate in a general population. Eur Heart J, 29 (2008), pp. 2014-2023.

[45] Dalen H., A. Thorstensen, S.A. Aase, C.B. Ingul, H. Torp, L.J. Vatten. Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway.

[46] Yingchoncharoen T., S. Agarwal, Z.B. Popovic, T.H. Marwick. Normal ranges of left ventricular strain: a meta-analysis. J Am Soc Echocardiogr, 26 (2013), pp. 185-191.

[47] J.P. Sun, Z.B. Popovic, N.L. Greenberg, X.F. Xu, C.R. Asher, W.J. Stewart. Noninvasive quantification of regional myocardial function using Doppler-derived velocity, Zisplacement, strain rate, and strain in healthy volunteers: effects of aging. J Am Soc Echocardiogr, 17 (2004), pp. 132-138.

[48] J.P. Sun, A.P. Lee, C. Wu, Y.Y. Lam, M.J. Hung, L. Chen. Quantification of left ventricular regional myocardial function using two-dimensional speckle tracking echocardiography in healthy volunteers—a multi-center study. Int J Cardiol, 167 (2013), pp. 495-501.

[49] Zghal F., H. Bougteb, P. Réant, S. Lafitte, R. Roudaut. Assessing global and regional left ventricular myocardial function in elderly patients using the bidimensional strain method. Echocardiography, 28 (2011), pp. 978-982.

[50] C.G. Fonseca, H.C. Oxenham, B.R. Cowan, C.J. Occleshaw, A.A. Young. Aging alters patterns of regional nonuniformity in LV strain relaxation: a 3-D MR tissue tagging study. Am J Physiol Heart Circ Physiol, 285 (2003), pp. 621-630.

[51] K.A. Marcus, A.M. Mavinkurve-Groothuis, M. Barends, A. van Dijk, T. Feuth, C. De Korte. Reference values for myocardial two-dimensional strain echocardiography in a healthy pediatric and young adult cohort. J Am Soc Echocardiogr, 24 (2011), pp. 625-636.

[52] S. Cheng, M.G. Larson, E.L. McCabe, E. Osypiuk, B.T. Lehman, P. Stanchev. Age- and sex-based reference limits and clinical correlates of myocardial strain and synchrony: the ramingham Heart Study. Circ Cardiovasc Imaging, 6 (2013), pp. 692-699.

[53] D. Muraru, L.P. Badano, D. Peluso, L. Dal Bianco, S. Casablanca, G. Kocabay. Comprehensive analysis of left ventricular geometry and function by three-dimensional echocardiography in healthy adults. J Am Soc Echocardiogr, 26 (2013), pp. 618-628.

[54] H.K. Kim, D.W. Sohn, S.E. Lee, S.Y. Choi, J.S. Park, Y.J. Kim. Assessment of left ventricular rotation and torsion with two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr, 20 (2007), pp. 45-53.

[55] Maharaj N., F. Peters, B.K. Khandheria, E. Libhaber, M.R. Essop. Left ventricular twist in a normal African adult population. Eur Heart J Cardiovasc Imaging, 14 (2013), pp. 526-533.

[56] Y. Notomi, G. Srinath, T. Shiota, M.G. Martin-Miklovic, L. Beachler, K. Howell. Maturational and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. Circulation, 113 (2006), pp. 2534-2541.

[57] Nelson MR, Hurst RT, Raslan SF, Cha S, Wilansky S, Lester SJ. Echocardiographic measures of myocardial deformation by speckle-tracking technologies: the need for standardization? J Am Soc Echocardiogr. 2012; 25:1189-94.

[58] Thomas JD, Badano LP. EACVI-ASE-industry initiative to standardize deformation imaging: A brief update from the co-chairs, Eur Heart J Cardiovasc Imag. 2013; 14:1039-40.