Regional longitudinal strain patterns according to left ventricular hypertrophy in the general population

Area of Science:

• Cardiology
• Echocardiography
• Cardiovascular Imaging

Background:

• Reduced basal longitudinal strain (BLS) is a known pattern in left ventricular hypertrophy (LVH).
• The prognostic significance of this strain pattern, particularly its regional variations, in relation to cardiovascular outcomes remains unclear.

Purpose of the Study:

• To investigate the prognostic value of regional longitudinal strain, specifically BLS and midventricular strain, in individuals with and without LVH.
• To assess the association of these strain parameters with major adverse cardiovascular events (MACE).

Main Methods:

• Utilized echocardiography with speckle tracking in 1090 participants from the 4th Copenhagen City Heart Study.
• Stratified participants based on the presence of LVH (defined by LV mass index).
• Followed participants for a median of 14.7 years to record MACE (myocardial infarction, heart failure, cardiovascular death).

Main Results:

• BLS and midventricular strain showed incremental impairment across the spectrum from normal geometry to LVH.
• Both BLS and midventricular strain were independently associated with MACE in participants with LVH (P=0.041 for both).
• No significant association was found between these strain parameters and MACE in participants without LVH.

Conclusions:

• Impaired BLS and midventricular strain are characteristic of LVH and worsen progressively with increasing LVH.
• These regional strain measures serve as independent predictors of MACE in individuals with LVH.