Skaarup Kristoffer Grundtvig, Lassen Mats Christian Højbjerg, Johansen Niklas Dyrby, Olsen Flemming Javier, Lind Jannie Nørgaard, Jørgensen Peter Godsk, Jensen Gorm, Schnohr Peter, Prescott Eva, Søgaard Peter, Møgelvang Rasmus, Biering-Sørensen Tor
Department of Cardiology, Herlev and Gentofte University Hospital, Kildegårdsvej 28, DK-2900, Post 835, Copenhagen, Denmark.
The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.
Eur Heart J Cardiovasc Imaging. 2022 Apr 18;23(5):629-640. doi: 10.1093/ehjci/jeab032.
Technical advancements in 2D-speckle tracking echocardiography (2DSTE) have allowed for quantification of layer-specific global longitudinal strain (GLS) and circumferential strain (GCS) of the left ventricle (LV). The aim of this study was to establish age- and sex-based reference ranges of peak systolic layer-specific GLS and GCS and to assess normal values of regional strain.
We performed 2DSTE analysis of 1997 members of the general population from the fifth round of the Copenhagen City Heart Study, who were free of cardiovascular disease and risk factors. The mean age was 46 ± 16 years (range 21-97) and 62% were female. Mean values for peak systolic whole wall GLS (GLSWW.Sys), endomycardial (GLSEndo.Sys), and epimyocardial (GLSEpi.Sys) were 19.9 ± 2.1% (prediction interval [PI]: 15.8-24.0%), 23.5 ± 2.5% (PI: 18.6-28.4%), and 17.3 ± 1.9% (PI: 13.6-21.1%), respectively. Mean peak systolic whole wall GCS (GCSWW.Sys), was 21.6 ± 3.7% (PI: 14.3-28.9%), endomyocardial (GCSEndo.Sys) was 31.9 ± 4.7% (PI: 22.7-41.1%), and epimyocardial (GCSEpi.Sys) was 14.3 ± 3.8% (PI: 6.8-21.8%). A significant discrepancy in normal strain values between males and females was observed. Men had lower mean values and lower reference limits for all strain parameters. Furthermore, GLS and GCS changed differently with age in males and females. Finally, regional LS decreased from the apical to the basal LV region in both sexes, and regional CS varied significantly by LV segment.
In this study, we reported age- and sex-based reference ranges of layer-specific GLS and GCS. These reference ranges varied significantly with sex and age.
二维斑点追踪超声心动图（2DSTE）技术的进步使得能够对左心室（LV）的各层特异性整体纵向应变（GLS）和圆周应变（GCS）进行量化。本研究的目的是建立基于年龄和性别的收缩期峰值各层特异性GLS和GCS的参考范围，并评估区域应变的正常值。
我们对哥本哈根市心脏研究第五轮中的1997名普通人群进行了2DSTE分析，这些人无心血管疾病及危险因素。平均年龄为46±16岁（范围21 - 97岁），62%为女性。收缩期峰值全壁GLS（GLSWW.Sys）、心内膜（GLSEndo.Sys）和心外膜（GLSEpi.Sys）的平均值分别为19.9±2.1%（预测区间[PI]：15.8 - 24.0%）、23.5±2.5%（PI：18.6 - 28.4%）和17.3±1.9%（PI：13.6 - 21.1%）。收缩期峰值全壁GCS（GCSWW.Sys）的平均值为21.6±3.7%（PI：14.3 - 28.9%），心内膜（GCSEndo.Sys）为31.9±4.7%（PI：22.7 - 41.1%），心外膜（GCSEpi.Sys）为14.3±3.8%（PI：6.8 - 21.8%）。观察到男性和女性的正常应变值存在显著差异。男性所有应变参数的平均值和参考下限均较低。此外，男性和女性的GLS和GCS随年龄变化的方式不同。最后，两性的区域纵向应变从左心室心尖部到基底部均降低，且区域圆周应变在左心室各节段差异显著。
在本研究中，我们报告了基于年龄和性别的各层特异性GLS和GCS的参考范围。这些参考范围随性别和年龄有显著差异。
