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Normal 2-dimensional strain values of the left ventricle: A substudy of the NORMAL (Normal echOcardiogRaphic Measurements in KoreAn popuLation) study
Jae-Hyeong Park1, Ju-Hee Lee2, Sang Yeub Lee2, Jin-Oh Choi3, Mi-Seung Shin4, Mi-Jeong Kim5, Hae Ok Jung6, Jeong Rang Park7, Il Suk Sohn8, Hyungseop Kim9, Seong-Mi Park10, Nam Jin Yoo11, Jung Hyun Choi12, Hyung-Kwan Kim13, Goo-Yeong Cho14, Mi-Rae Lee15, Jin-Sun Park16, Chi Young Shim17, Dae-Hee Kim18, Dae-Hee Shin19, Gil Ja Shin20, Sung Hee Shin21, Kye-Hun Kim22, Woo-Shik Kim23, Seung Woo Park3*
1Chungnam National University
2Chungbuk National University
3Samsung Medical Center Dept. of Med.
4Gil hospital, Gachon University
5Inchoen St. Mary's Hospital
6Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
7Gyeongsang National University
8Kyung Hee University School of Medicine, Kyung Hee University Hospital
9Keimyung University Dongsan Medical Center
10Korea University College of Medicine
11Wonkwang University Hospital
12Pusan National University
13Seoul National University College of Medicine
14Seoul National University Bundang Hospital
15Samsung Changwon Hospital, Sungkyunkwan University School of Medicine
16Ajou University School of Medicine
17Yonsei University College of Medicine
18Asan Medical Center, University of Ulsan College of Medicine
19Gangneung Asan Hospital, University of Ulsan College of Medicine
20Ewha Womans University School of Medicine
21Inha University College of Medicine
22Chonnam National University Hospital
23Kyung Hee University Medical Center
Corresponding Author: Seung Woo Park ,Email: parksmc@gmail.com
ABSTRACT
Background:
It is important to understand the distribution of 2-dimensional strain values, as assessed by standardized echocardiographic methods, in the normal population. We performed a multicenter trial to measure normal echocardiographic values in the Korean population.
Methods:
This was a substudy of the NORMAL (Normal echOcardiogRaphic diMensions and functions in KoreAn peopLe) study. The strain values were analyzed from digitally stored images using EchoPAC PC software (BT13, GE Medical, Horten, Norway).
Results:
A total of 1003 healthy participants were enrolled. Two-dimensional strain values were measured in 501 of these subjects (265 females, mean age 47±15 years old) for whom images acquired by echocardiographic machines (GE Medical) were available. Interventricular septal thickness, left ventricular (LV) posterior wall thickness, systolic and diastolic LV internal dimensions, and LV ejection fraction values were 7.5±1.0 mm, 7.4±1.0 mm, 29.9±2.8 mm, 48.9±3.6 mm, and 62±4%, respectively. The LV longitudinal systolic strain (LVLS) values of the apical 4-chamber (A4C) view, apical 3-chamber (A3C) view, apical 2-chamber (A2C) view, and LV global LS (LVGLS) were -20.1±2.3, -19.9±2.7, -21.2±2.6, and -20.4±2.2%, respectively. The LV longitudinal systolic strain rate (LVLSR) values of the A4C view, A3C view, A2C view, and LV global LSR (LVGLSR) were -1.18±0.18, -1.20±0.21, -1.25±0.21, and -1.21±0.17-s, respectively. Females had lower LVGLS (-21.2±2.2 vs. -19.5±1.9%, p<0.001) and LVGLSR (-1.25±0.18 vs. -1.17±0.15, p<0.001) values than males.
Conclusion:
We measured LVLS and LVLSR values in the normal Korean population. Since considerable differences were observed between men and women, normal echocardiographic cutoff values should be differentially applied based on sex.
Keywords: Echocardiography, Strain, Normal population, Reference value
Volume 25, No 3
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