Leitman Marina, Tyomkin Vladimir
Department of Cardiology, Shamir Medical Center, Zerifin 70300, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
J Cardiovasc Dev Dis. 2025 Jan 31;12(2):53. doi: 10.3390/jcdd12020053.
Quantitative evaluation of myocardial function traditionally relies on parameters such as ejection fraction and strain. Strain, reflecting the relative change in the length of a myocardial segment over the cardiac cycle, has been extensively studied in various cardiac pathologies over the past two decades. However, the absolute length change, or longitudinal displacement, of myocardial segments during the cardiac cycle has received limited attention. This study aims to evaluate longitudinal displacement in two separate groups: healthy athletes and patients with left ventricular dysfunction, providing new insights into myocardial function assessment.
Echocardiographic examinations were performed on 30 healthy football players and 30 patients with left ventricular dysfunction using speckle-tracking imaging analysis. Global and regional peak longitudinal displacement values were calculated and compared with corresponding global and regional peak longitudinal strain measurements. A manual alternative for calculating global longitudinal strain was also proposed.
An inverse correlation was found between regional longitudinal displacement and regional longitudinal strain. Longitudinal displacement was maximal in the basal segments and lowest in the apex of the left ventricle, exhibiting a reversed basal-to-apical gradient (17.6 ± 3.5 mm vs. 11.5 ± 2.9 mm vs. 4.22 ± 1.7 mm in basal, mid, and apical segments, respectively; < 0.000001). Maximal longitudinal displacement was observed in the inferior and posterior walls of the left ventricle. In the 30 patients with left ventricular dysfunction, global longitudinal displacement was significantly lower than in healthy individuals (4.4 ± 1.7 mm vs. 11.7 ± 1.5 mm, < 0.000001). Global longitudinal displacement and global longitudinal strain showed a strong negative correlation (r = -0.72, < 0.000001). Manually calculated global longitudinal strain demonstrated good agreement with speckle-tracking-based global longitudinal strain.
Peak longitudinal displacement can be used to evaluate both regional and global myocardial function, similarly to peak longitudinal strain. Unlike strain, longitudinal displacement exhibits a reversed basal-to-apical gradient, with the highest values at the base of the left ventricle and the lowest at the apex. Global and regional longitudinal displacement is significantly reduced in patients with left ventricular dysfunction. Global longitudinal strain can be manually calculated using displacement measurements. Further studies are needed to evaluate peak longitudinal displacement in various cardiac pathologies.
心肌功能的定量评估传统上依赖于诸如射血分数和应变等参数。应变反映了心肌节段在心动周期中的长度相对变化，在过去二十年中已在各种心脏疾病中得到广泛研究。然而，心肌节段在心动周期中的绝对长度变化，即纵向位移，受到的关注有限。本研究旨在评估两个不同组别的纵向位移：健康运动员和左心室功能障碍患者，为心肌功能评估提供新的见解。
对30名健康足球运动员和30名左心室功能障碍患者进行超声心动图检查，采用斑点追踪成像分析。计算整体和局部峰值纵向位移值，并与相应的整体和局部峰值纵向应变测量值进行比较。还提出了一种手动计算整体纵向应变的替代方法。
发现局部纵向位移与局部纵向应变呈负相关。纵向位移在基底节段最大，在左心室心尖最低，呈现出相反的基底到心尖梯度（基底、中间和心尖节段分别为17.6±3.5mm、11.5±2.9mm和4.22±1.7mm；<0.000001）。在左心室下壁和后壁观察到最大纵向位移。在30名左心室功能障碍患者中，整体纵向位移明显低于健康个体（4.4±1.7mm对11.7±1.5mm，<0.000001）。整体纵向位移和整体纵向应变呈强负相关（r=-0.72，<0.000001）。手动计算的整体纵向应变与基于斑点追踪的整体纵向应变显示出良好的一致性。
峰值纵向位移可用于评估局部和整体心肌功能，与峰值纵向应变类似。与应变不同，纵向位移呈现出相反的基底到心尖梯度，在左心室基底处值最高，在心尖处最低。左心室功能障碍患者的整体和局部纵向位移明显降低。整体纵向应变可使用位移测量值手动计算。需要进一步研究以评估各种心脏疾病中的峰值纵向位移。
