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Strain, strain rate, and the force frequency relationship in patients with and without heart failure

Susanna Mak1, Harriette G C Van Spall, Rodrigo V Wainstein

  • 1The Mecklinger and Posluns Cardiac Catheterization Research Laboratory, Division of Cardiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. smak@mtsinai.on.ca

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|December 6, 2011
PubMed

Insights

Increasing heart rate (HR) improves contractility but decreases longitudinal strain in heart failure (HF) patients. Strain rate is less affected by HR changes, making it more reliable for quantitative stress imaging.

Area of Science:

  • Cardiology
  • Cardiac Physiology
  • Echocardiography

Background:

  • Heart rate (HR) influences cardiac contractility and function.
  • Understanding the force-frequency relationship is crucial in heart failure (HF).
  • Previous studies have not fully elucidated HR effects on deformation indices in HF.

Purpose of the Study:

  • To investigate the impact of controlled heart rate variations on left ventricular (LV) deformation indices.
  • To describe the force-frequency relationship in adults with and without systolic HF.
  • To compare the response of longitudinal strain and strain rate to changes in HR.

Main Methods:

  • Simultaneous high-fidelity left ventricular (LV) catheterization and two-dimensional echocardiography.
  • Right atrial pacing to control heart rate (HR) and record LV pressure.
  • Speckle-tracking echocardiography for strain and strain rate analysis.

Main Results:

  • Patients with HF exhibited reduced isovolumic contractility, longitudinal strain, and strain rate.
  • Both normal and HF groups demonstrated HR-dependent increases in LV+dP/dt(max) (force-frequency relationship).
  • Longitudinal strain significantly decreased with increasing HR in both groups, linked to reduced LV end-diastolic dimensions; strain rate remained unchanged.

Conclusions:

  • Increasing HR enhances contractility but reduces longitudinal strain, similar to stroke volume changes.
  • Strain rate is less sensitive to HR-induced contractility changes, suggesting its utility in quantitative stress imaging.
  • Longitudinal strain reflects load-dependent changes influenced by HR, while strain rate offers a more stable measure of contractility.
Abstract

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