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Systolic longitudinal strain correlates with visual assessment of regional left ventricular function during dobutamine stress echocardiography and discriminates the segments with induced contractility impairment
Author(s) -
WierzbowskaDrabik Karina,
Miśkowiec Dawid,
Kasprzak Jarosław D.
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13582
Subject(s) - contractility , cardiology , medicine , dobutamine , ventricular function , stage (stratigraphy) , hemodynamics , paleontology , biology
Background The relationship between visual and strain assessment of left ventricular ( LV ) function during dobutamine stress echocardiography ( DSE ) remains poorly investigated. We assessed systolic longitudinal strain ( SLS ) and strain rate ( SLSR ) in segments visually graded as normokinetic, hypokinetic, or akinetic at baseline (0) and peak stage (1) of DSE and compared deformation changes between segments with and without induced contractility worsening. Methods From 250 patients examined by DSE , 238 patients with diagnostic test were included, mean age of 62±9 years (105 females). Regional LV contractility was assessed visually and measured using SLS and SLSR in 4284 segments. Results The LV segments during baseline and peak stage of DSE revealed gradual decrease in absolute values of SLS (from 17.7±6.4% in normokinetic to 11.7±8.4% in akinetic segments at rest, and from 17.2±8.5% to 14.4±7.8% at peak, P <.001), as measured by automated function imaging ( AFI ) and SLSR (from 1.1±0.37 s −1 in normokinetic to 0.9±0.29 s −1 in akinetic at rest, and from 2.32±0.92 to 2.13±0.85 s −1 at peak). The decrease in SLS in segments with contractility worsening was higher than in segments without induced impairment (Δ SLS 2% vs 0%, P <.0001 for all LV segments and 2% vs 1%, P =.02 in mid‐ LV segments). Absolute value of regional SLS <23% at peak DSE and decrease in SLS >2% from baseline showed 90% and 76% sensitivity for the detection of contractility impairment. Conclusion Strain analysis quantifies segmental LV contractility not only at rest and peak DSE but may be helpful in detection of stress‐induced contractility worsening.