Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Sep;6(5):692-9.
doi: 10.1161/CIRCIMAGING.112.000627. Epub 2013 Aug 5.

Age- and sex-based reference limits and clinical correlates of myocardial strain and synchrony: the Framingham Heart Study

Susan Cheng  1 , Martin G Larson, Elizabeth L McCabe, Ewa Osypiuk, Birgitta T Lehman, Plamen Stanchev, Jayashri Aragam, Emelia J Benjamin, Scott D Solomon, Ramachandran S Vasan
Affiliations

Age- and sex-based reference limits and clinical correlates of myocardial strain and synchrony: the Framingham Heart Study

Susan Cheng et al. Circ Cardiovasc Imaging. 2013 Sep.

Abstract

Background: There is rapidly growing interest in applying measures of myocardial strain and synchrony in clinical investigations and in practice; data are limited regarding their reference ranges in healthy individuals.

Methods and results: We performed speckle-tracking-based echocardiographic measures of left ventricular myocardial strain and synchrony in healthy adults (n=739, mean age 63 years, 64% women) without cardiovascular disease. Reference values were estimated using quantile regression. Age- and sex-based upper (97.5th quantile) limits were: -14.4% to -17.1% (women) and -14.4 to -15.2% (men) for longitudinal strain; -22.3% to -24.7% (women) and -17.9% to -23.7% (men) for circumferential strain; 121 to 165 ms (women) and 143 to 230 ms (men) for longitudinal segmental synchrony (SD of regional time-to-peak strains); and 200 to 222 ms (women) and 216 to 303 ms (men) for transverse segmental synchrony. In multivariable analyses, women had ≈1.7% greater longitudinal strain, ≈2.2% greater transverse strain, and ≈3.2% greater circumferential strain (P<0.0001 for all) compared with men. Older age and higher diastolic blood pressure, even within the normal range, were associated with worse transverse segmental synchrony (P<0.001). Overall, covariates contributed to ≤12% of the variation in myocardial strain or synchrony in this healthy sample.

Conclusions: We estimated age- and sex-specific reference limits for measures of left ventricular strain and synchrony in a healthy community-based sample, wherein clinical covariates contributed to only a modest proportion of the variation. These data may facilitate the interpretation of left ventricular strain-based measures obtained in future clinical research and practice.

Keywords: echocardiography; left ventricular function; reference values.

PubMed Disclaimer

Figures

Figure
Figure
Quantile regression reference limits in men and women are shown for each of the primary measures of myocardial deformation and synchrony: global longitudinal strain (Panel A), global transverse strain (Panel B), mid-ventricular average circumferential strain (Panel C), mid-ventricular average radial strain (Panel D), longitudinal segmental synchrony (Panel E), and transverse segmental synchrony (Panel F).
See this image and copyright information in PMC

References

    1. Shah AM, Solomon SD. Myocardial deformation imaging: Current status and future directions. Circulation. 2012;125:e244–248. - PubMed
    1. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: Ase/eae consensus statement on methodology and indications endorsed by the japanese society of echocardiography. Eur J Echocardiogr. 2011;12:167–205. - PubMed
    1. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, Galderisi M, Marwick T, Nagueh SF, Sengupta PP, Sicari R, Smiseth OA, Smulevitz B, Takeuchi M, Thomas JD, Vannan M, Voigt JU, Zamorano JL. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: Ase/eae consensus statement on methodology and indications endorsed by the japanese society of echocardiography. J Am Soc Echocardiogr. 2011;24:277–313. - PubMed
    1. Zerhouni EA, Parish DM, Rogers WJ, Yang A, Shapiro EP. Human heart: Tagging with mr imaging--a method for noninvasive assessment of myocardial motion. Radiology. 1988;169:59–63. - PubMed
    1. Shehata ML, Cheng S, Osman NF, Bluemke DA, Lima JA. Myocardial tissue tagging with cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2009;11:55. - PMC - PubMed

Publication types

LinkOut - more resources