Diastolic wall strain: a simple marker of abnormal cardiac mechanics
Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely relate...
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| creator | Selvaraj, Senthil Aguilar, Frank G Martinez, Eva E Beussink, Lauren Kim, Kwang-Youn A Peng, Jie Lee, Daniel C Patel, Ateet Sha, Jin Irvin, Marguerite R Arnett, Donna K Shah, Sanjiv J |
| description | Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics.
We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] |
| doi_str_mv | 10.1186/1476-7120-12-40 |
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We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] <50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e') tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N=35).
In HyperGEN (age 51 ± 14 years, 59% female, 45% African-American, 57% hypertensive), mean DWS was 0.38 ± 0.05. DWS decreased with increasing comorbidity burden (β-coefficient -0.013 [95% CI -0.015, -0.011]; P<0.0001). DWS was independently associated with GLS, GCS, GRS, and e' velocity (adjusted P<0.05) but not LV chamber compliance (EDV20, P=0.97). On prospective speckle-tracking analysis, DWS correlated well with GLS, GCS, and GRS (R=0.61, 0.57, and 0.73, respectively; P<0.001 for all comparisons). C-statistics for DWS as a diagnostic test for abnormal GLS, GCS, and GRS were: 0.78, 0.79, and 0.84, respectively.
DWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e') tissue velocities but not LV chamber compliance.</description><identifier>ISSN: 1476-7120</identifier><identifier>EISSN: 1476-7120</identifier><identifier>DOI: 10.1186/1476-7120-12-40</identifier><identifier>PMID: 25277882</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Analysis ; Biomarkers ; Blood pressure ; Diabetes ; Diastole ; Drug therapy ; Echocardiography - statistics & numerical data ; Elastic Modulus ; Elasticity Imaging Techniques - statistics & numerical data ; Epidemiology ; Female ; Health care ; Heart attacks ; Heart failure ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Humans ; Hypertension ; Hypertension - diagnostic imaging ; Hypertension - epidemiology ; Hypertension - physiopathology ; Image Interpretation, Computer-Assisted - methods ; Kidney diseases ; Laboratories ; Male ; Mechanics ; Medical equipment and supplies industry ; Medical test kit industry ; Middle Aged ; Mortality ; Physiological aspects ; Prevalence ; Preventive medicine ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Stress, Mechanical ; United States - epidemiology ; Validation studies ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - epidemiology ; Ventricular Dysfunction, Left - physiopathology</subject><ispartof>Cardiovascular Ultrasound, 2014-10, Vol.12 (1), p.40-40, Article 40</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Selvaraj et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Selvaraj et al.; licensee BioMed Central Ltd. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-3d5cc997adf65e09d984207a7abea9592e5a0677ca62b40ae03eeee411de2f4c3</citedby><cites>FETCH-LOGICAL-c521t-3d5cc997adf65e09d984207a7abea9592e5a0677ca62b40ae03eeee411de2f4c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197332/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197332/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25277882$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selvaraj, Senthil</creatorcontrib><creatorcontrib>Aguilar, Frank G</creatorcontrib><creatorcontrib>Martinez, Eva E</creatorcontrib><creatorcontrib>Beussink, Lauren</creatorcontrib><creatorcontrib>Kim, Kwang-Youn A</creatorcontrib><creatorcontrib>Peng, Jie</creatorcontrib><creatorcontrib>Lee, Daniel C</creatorcontrib><creatorcontrib>Patel, Ateet</creatorcontrib><creatorcontrib>Sha, Jin</creatorcontrib><creatorcontrib>Irvin, Marguerite R</creatorcontrib><creatorcontrib>Arnett, Donna K</creatorcontrib><creatorcontrib>Shah, Sanjiv J</creatorcontrib><title>Diastolic wall strain: a simple marker of abnormal cardiac mechanics</title><title>Cardiovascular Ultrasound</title><addtitle>Cardiovasc Ultrasound</addtitle><description>Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics.
We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] <50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e') tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N=35).
In HyperGEN (age 51 ± 14 years, 59% female, 45% African-American, 57% hypertensive), mean DWS was 0.38 ± 0.05. DWS decreased with increasing comorbidity burden (β-coefficient -0.013 [95% CI -0.015, -0.011]; P<0.0001). DWS was independently associated with GLS, GCS, GRS, and e' velocity (adjusted P<0.05) but not LV chamber compliance (EDV20, P=0.97). On prospective speckle-tracking analysis, DWS correlated well with GLS, GCS, and GRS (R=0.61, 0.57, and 0.73, respectively; P<0.001 for all comparisons). C-statistics for DWS as a diagnostic test for abnormal GLS, GCS, and GRS were: 0.78, 0.79, and 0.84, respectively.
DWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e') tissue velocities but not LV chamber compliance.</description><subject>Analysis</subject><subject>Biomarkers</subject><subject>Blood pressure</subject><subject>Diabetes</subject><subject>Diastole</subject><subject>Drug therapy</subject><subject>Echocardiography - statistics & numerical data</subject><subject>Elastic Modulus</subject><subject>Elasticity Imaging Techniques - statistics & numerical data</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health care</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - diagnostic imaging</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Image Interpretation, Computer-Assisted - methods</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mechanics</subject><subject>Medical equipment and supplies industry</subject><subject>Medical test kit industry</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Physiological aspects</subject><subject>Prevalence</subject><subject>Preventive medicine</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Stress, Mechanical</subject><subject>United States - epidemiology</subject><subject>Validation studies</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - epidemiology</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><issn>1476-7120</issn><issn>1476-7120</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkc1vFSEUxYmxsbW6dmdI3LiZlo8BBhcmTetHkyZudE3uY-60VAae8F6N_71MXn2pXRUWkMvvnhzuIeQNZyecD_qU90Z3hgvWcdH17Bk52leeP7gfkpe13jImBJfDC3IolDBmGMQRubgIUDc5Bk9_Q4y0bgqE9IECrWFeR6QzlJ9YaJ4orFIuM0TqoYwBPJ3R30AKvr4iBxPEiq_vz2Py4_On7-dfu6tvXy7Pz646rwTfdHJU3ltrYJy0QmZHO_SCGTCwQrDKClTAtDEetFj1DJBJbKvnfEQx9V4ek4873fV2NePoMTW30a1LaC7_uAzB_f-Swo27zneu59ZIKZrA-3uBkn9tsW7cHKrHGCFh3lbHNR-40sw8CRViGJS1DX33CL3N25LaJBaKN0qrhTrZUdcQ0YU05WbRtz3iHHxOOIVWP1PSaiUsk63hdNfgS6614LT_KGduSd8t-bolX8eF61nrePtwPnv-X9zyL3r8qXE</recordid><startdate>20141003</startdate><enddate>20141003</enddate><creator>Selvaraj, Senthil</creator><creator>Aguilar, Frank G</creator><creator>Martinez, Eva E</creator><creator>Beussink, Lauren</creator><creator>Kim, Kwang-Youn A</creator><creator>Peng, Jie</creator><creator>Lee, Daniel C</creator><creator>Patel, Ateet</creator><creator>Sha, Jin</creator><creator>Irvin, Marguerite R</creator><creator>Arnett, Donna K</creator><creator>Shah, Sanjiv J</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QO</scope><scope>5PM</scope></search><sort><creationdate>20141003</creationdate><title>Diastolic wall strain: a simple marker of abnormal cardiac mechanics</title><author>Selvaraj, Senthil ; Aguilar, Frank G ; Martinez, Eva E ; Beussink, Lauren ; Kim, Kwang-Youn A ; Peng, Jie ; Lee, Daniel C ; Patel, Ateet ; Sha, Jin ; Irvin, Marguerite R ; Arnett, Donna K ; Shah, Sanjiv J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-3d5cc997adf65e09d984207a7abea9592e5a0677ca62b40ae03eeee411de2f4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Analysis</topic><topic>Biomarkers</topic><topic>Blood pressure</topic><topic>Diabetes</topic><topic>Diastole</topic><topic>Drug therapy</topic><topic>Echocardiography - statistics & numerical data</topic><topic>Elastic Modulus</topic><topic>Elasticity Imaging Techniques - statistics & numerical data</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health care</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - diagnostic imaging</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Image Interpretation, Computer-Assisted - methods</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Male</topic><topic>Mechanics</topic><topic>Medical equipment and supplies industry</topic><topic>Medical test kit industry</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Physiological aspects</topic><topic>Prevalence</topic><topic>Preventive medicine</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Stress, Mechanical</topic><topic>United States - 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Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cardiovascular Ultrasound</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Selvaraj, Senthil</au><au>Aguilar, Frank G</au><au>Martinez, Eva E</au><au>Beussink, Lauren</au><au>Kim, Kwang-Youn A</au><au>Peng, Jie</au><au>Lee, Daniel C</au><au>Patel, Ateet</au><au>Sha, Jin</au><au>Irvin, Marguerite R</au><au>Arnett, Donna K</au><au>Shah, Sanjiv J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diastolic wall strain: a simple marker of abnormal cardiac mechanics</atitle><jtitle>Cardiovascular Ultrasound</jtitle><addtitle>Cardiovasc Ultrasound</addtitle><date>2014-10-03</date><risdate>2014</risdate><volume>12</volume><issue>1</issue><spage>40</spage><epage>40</epage><pages>40-40</pages><artnum>40</artnum><issn>1476-7120</issn><eissn>1476-7120</eissn><abstract>Diastolic wall strain (DWS), defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS = [PWT(systole)-PWT(diastole)]/PWT(systole)), has been proposed as a marker of left ventricular (LV) diastolic stiffness. However, the equation for DWS is closely related to systolic radial strain, and whether DWS is associated with abnormal cardiac mechanics (reduced systolic strains and diastolic tissue velocities) is unknown. We sought to determine the relationship between DWS and systolic and diastolic cardiac mechanics.
We calculated DWS and performed speckle-tracking analysis in a large population- and family-based study (Hypertension Genetic Epidemiology Network [HyperGEN]; N=1907 after excluding patients with ejection fraction [EF] <50% or posterior wall motion abnormalities). We measured global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively) and early diastolic (e') tissue velocities, and we determined the independent association of DWS with cardiac mechanics using linear mixed effects models to account for relatedness among study participants. We also prospectively performed receiver-operating characteristic (ROC) analysis of DWS for the detection of abnormal cardiac mechanics in a separate, prospective validation study (N=35).
In HyperGEN (age 51 ± 14 years, 59% female, 45% African-American, 57% hypertensive), mean DWS was 0.38 ± 0.05. DWS decreased with increasing comorbidity burden (β-coefficient -0.013 [95% CI -0.015, -0.011]; P<0.0001). DWS was independently associated with GLS, GCS, GRS, and e' velocity (adjusted P<0.05) but not LV chamber compliance (EDV20, P=0.97). On prospective speckle-tracking analysis, DWS correlated well with GLS, GCS, and GRS (R=0.61, 0.57, and 0.73, respectively; P<0.001 for all comparisons). C-statistics for DWS as a diagnostic test for abnormal GLS, GCS, and GRS were: 0.78, 0.79, and 0.84, respectively.
DWS, a simple parameter than can be calculated from routine 2D echocardiography, is closely associated with systolic strain parameters and early diastolic (e') tissue velocities but not LV chamber compliance.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25277882</pmid><doi>10.1186/1476-7120-12-40</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Biomarkers Blood pressure Diabetes Diastole Drug therapy Echocardiography - statistics & numerical data Elastic Modulus Elasticity Imaging Techniques - statistics & numerical data Epidemiology Female Health care Heart attacks Heart failure Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Humans Hypertension Hypertension - diagnostic imaging Hypertension - epidemiology Hypertension - physiopathology Image Interpretation, Computer-Assisted - methods Kidney diseases Laboratories Male Mechanics Medical equipment and supplies industry Medical test kit industry Middle Aged Mortality Physiological aspects Prevalence Preventive medicine Reproducibility of Results Risk Factors Sensitivity and Specificity Stress, Mechanical United States - epidemiology Validation studies Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - epidemiology Ventricular Dysfunction, Left - physiopathology |
| title | Diastolic wall strain: a simple marker of abnormal cardiac mechanics |
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