Age- and sex-specific reference values of biventricular strain and strain rate derived from a large cohort of healthy Chinese adults: a cardiovascular magnetic resonance feature tracking study

Abstract

Background As a noninvasive tool, myocardial deformation imaging may facilitate the early detection of cardiac dysfunction. However, normal reference ranges of myocardial strain and strain rate (SR) based on large-scale East Asian populations are still lacking. This study aimed to provide reference values of left ventricular (LV) and right ventricular (RV) strain and SR based on a large cohort of healthy Chinese adults using cardiovascular magnetic resonance (CMR) feature tracking (FT). Methods Five hundred and sixty-six healthy Chinese adults (55.1% men) free of hypertension, diabetes, and obesity were included. On cine CMR, biventricular global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS), and the peak radial, circumferential, and longitudinal systolic, and diastolic SRs (PSSRR, PSSRC, PSSRL, PDSRR, PDSRC, and PDSRL), and regional radial and circumferential strain at the basal, mid-cavity, and apical levels were measured. Associations of global and regional biventricular deformation indices with age and sex were investigated. Results Women demonstrated greater magnitudes of LV GRS (37.6 ± 6.1% vs. 32.1 ± 5.3%), GCS (− 20.7 ± 1.9% vs. − 18.8 ± 1.9%), GLS (− 17.8 ± 1.8% vs. − 15.6 ± 1.8%), RV GRS (25.1 ± 7.8% vs. 22.1 ± 6.7%), GCS (− 14.4 ± 3.6% vs. − 13.2 ± 3.2%), GLS (− 22.4 ± 5.2% vs. − 20.2 ± 4.6%), and biventricular peak systolic and diastolic SR in all three coordinate directions (all P < 0.05). For the LV, aging was associated with increasing amplitudes of GRS, GCS, and decreasing amplitudes of PDSRR, PDSRC, PDSRL (all P < 0.05). For the RV, aging was associated with an increase in the magnitudes of GRS, GCS, GLS, PSSRR, PSSRC, PSSRL, and a decrease in the magnitude of PDSRR, PDSRC (all P < 0.05). Biventricular radial and circumferential strain measurements at the basal, mid-cavity, and apical levels were all significantly related to age and sex in both sexes (all P < 0.05). Conclusions We provide age- and sex-specific normal values of biventricular strain and SR based on a large sample of healthy Chinese adults with a broad age range. These results may be served as a reference standard for cardiac function assessment, especially for the Chinese population.

Biventricular Tissue Tracking with Cardiovascular Magnetic Resonance: Reference Values of Left- and Right-Ventricular Strain

“…Of note, our article is the only one to calculate radial strain from both long-axis and short-axis planes, while, in almost all previous studies, horizontal long-axis cines were tracked to derive longitudinal strain, while short-axis cines were used to derive circumferential and radial strain. Moreover, the gender differences in myocardial strain are in agreement with previous studies [ 11 , 12 , 13 ], while the relationship between age and strain values has shown conflicting results. In particular, differently from our results, several previous studies reported an age-related increase in LV GCS [ 11 , 12 , 13 ], LV GRS [ 12 , 13 , 14 ], and all RV strains [ 13 ].…”

“…Moreover, the gender differences in myocardial strain are in agreement with previous studies [ 11 , 12 , 13 ], while the relationship between age and strain values has shown conflicting results. In particular, differently from our results, several previous studies reported an age-related increase in LV GCS [ 11 , 12 , 13 ], LV GRS [ 12 , 13 , 14 ], and all RV strains [ 13 ]. On the other hand, in children, all global LV strains showed a significant parabolic relation to age and an even stronger one to BSA, but no gender differences [ 15 ].…”

“…In each slice, the anterior insertion of the right ventricle was manually defined and used to define the segments (six in basal and mid-ventricular slices and four in apical slice). For further statistical analysis, segments were grouped according to level (basal: segments 1-6; mid-ventricular: segments 7-12; apical: segments [12][13][14][15][16].…”

Effects of acromegaly treatment on left ventricular systolic function assessed by speckle tracking echocardiography in relation to sex differences: results from a prospective single center study

“…Women with acromegaly, like women in the general population, have better GLS compared to men ( 30 ). Similar observations had researchers evaluating the heart of athletes by STE.…”

Serial Cardiac MRI for Quantification of the Dynamics of Anthracycline‐Induced Subclinical Myocardial Injury

“…Before the first chemotherapy, we compared the baseline values of the subjects with those of normal people in the previous studies [16][17][18] to exclude abnormal subjects.…”