Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium.
Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
Eur Heart J Cardiovasc Imaging. 2020 Aug 1;21(8):896-905. doi: 10.1093/ehjci/jeaa050.
To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages.
A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were -15.0% in men and -15.6% in women for epicardial strain, -16.8% and -17.7% for mid-myocardial strain, and -18.7% and -19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = -0.20, P = 0.007, mid-myocardial; r = -0.21, P = 0.006, endocardial; r = -0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1).
The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.
从广泛年龄范围内的大量男女健康志愿者中获得二维超声心动图（2DE）测量左心室（LV）层特异性应变的正常范围。
共有 287 名（109 名男性，平均年龄：46±14 岁）健康受试者参加了 EACVI 正常超声心动图参考范围（NORRE）研究的 22 个合作机构。使用 2DE 软件从心尖两腔、三腔和四腔视图分析层特异性应变。从平均值计算出的最低层特异性应变值为 -15.0%（男性）和 -15.6%（女性）为心外膜应变，-16.8%和-17.7%为中层心肌应变，-18.7%和-19.9%为心内膜应变。女性的基底心外膜和中层心肌应变随年龄而降低（心外膜；P=0.008，中层心肌；P=0.003），并与年龄相关（心外膜；r=-0.20，P=0.007，中层心肌；r=-0.21，P=0.006，心内膜；r=-0.23，P=0.002），而心尖心外膜和中层心肌应变随女性年龄而增加（心外膜；P=0.006，中层心肌；P=0.03），并与年龄相关（心外膜；r=0.16，P=0.04）。男性心尖部的 E/Epi 比值高于 LV 中部和基底水平（心尖部；1.6±0.2，中部；1.2±0.1，基底 1.1±0.1）和女性（心尖部；1.6±0.1，中部；1.1±0.1，基底 1.2±0.1）。
NORRE 研究为层特异性应变的新型指标提供了有用的 2DE 参考范围。
