Trend and Linearity Determination of Left Ventricular Mechanics in Cardiovascular Risk Factor Population with...

4-Dimensional XStrain speckle tracking echocardiography (4DXStrainSTE) is an advanced cardiac imaging technique that synthesizes speckle tracking echocardiography (STE) data obtained from the apical three-chamber (3CH), four-chamber (4CH), and two-chamber (2CH) views, thereby enabling a comprehensive evaluation of multiple left ventricular strain parameters (MLVSP) within a three-dimensional framework.

This study aimed to evaluate the impact of cardiovascular risk factors (CVRFs) on MLVSP using 4DXStrainSTE. Nine strain parameters were analyzed: global circumferential strain (GCS), global circumferential strain rate (GCSR), global radial strain (GRS), and global radial strain rate (GRSR) at the mitral valve (mv) and papillary muscle (pap) levels, along with global longitudinal strain (GLS). A total of 500 Indian adults (aged 18-60 years; both sexes) were enrolled. Participants were categorized into four CVRF Risk Categories (1, 2, 3, and 4) according to the cumulative number of risk factors. The inclusion criterion was a 4-dimensional left ventricular ejection fraction (4D-LVEF) ≥50%.

The impact of CVRFs on LV strain parameters displayed a significant decline in GLS, GCS at pap level, GCSR at mv and pap level, substantiated by trend analysis. Mild-to-moderate linear association across MLVSP was identified. Multivariate regression illustrated significant associations of GLS and GCSR at mv level with GLS across the risk categories.

This study illustrates a comprehensive evaluation of the consequences of CVRFs on MLVSP in individuals with preserved ejection fraction.