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Global longitudinal strain a helpful diagnostic tool for detecting myocardial dysfunction
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PARIS — Defining global longitudinal strain variance in a normal patient population may be used as a clinical decision-making tool to aid the clinician in the detection of myocardial dysfunction, according to a patient meta-analysis presented at the European Society of Cardiology Congress.
Nicholas D’Elia, BMSci (Hons), MBBS, GDip, of the Baker Heart and Diabetes Institute in Melbourne, Australia, and colleagues analyzed data from 16 studies published between 2011 and 2018. The studies included at least 20 healthy individuals older than 18 years who had reported speckle tracking-based global longitudinal strain.
Mean global longitudinal strain was 20.7. Eight of the 16 studies had individual data, which comprised 2,396 patients (mean age, 42 years).
The normal range for global longitudinal strain was 21%, although it significantly varied with age. Patients aged older than 60 years had lower global longitudinal strain compared with those younger than 60 years (20% vs. 21%; P < .01), while 2.8% of patients (mean age, 54 years) had a global longitudinal strain of less than 16%.
Normal global longitudinal strain ranges varied with common clinical covariates such as weight (beta = –0.03; P < .01), age and systolic BP (beta = –0.02; P < .01).
The findings are important because “they define normal (over 18%), borderline (16% to 18%) and abnormal function. Strain is a more sensitive marker than ejection fraction and is important for the recognition of stage B HF,” Thomas H. Marwick, MD, director of the Baker Heart and Diabetes Institute, told Cardiology Today. “Essentially, only about 2% of normal people have a global longitudinal strain under 16%, so there’s a pretty clear message about how to use the results.”
“We hope that the reported values may guide the clinician in detecting myocardial dysfunction,” D’Elia and colleagues wrote.
Marwick told Cardiology Today that it may be important in the future to use global longitudinal strain as a component of large randomized controlled trials, especially for HF with preserved ejection fraction.
The study was published simultaneously in JACC: Cardiovascular Imaging. – by Darlene Dobkowski
References:
D’Elia N, et al. Abstract 3076. Presented at: European Society of Cardiology Congress; Aug. 31-Sept. 4, 2019; Paris.
D’Elia N, et al. JACC Cardiovasc Imaging. 2019;doi:10.1016/j.jcmg.2019.07.020.
Disclosures: The authors report no relevant financial disclosures.