Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

  • Park, Jae-Hyeong (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Lee, Ju-Hee (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Lee, Sang Yeub (Division of Cardiology, Department of Internal Medicine, Chungbuk National University School of Medicine) ;
  • Choi, Jin-Oh (Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Mi-Seung (Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University of Medicine and Science) ;
  • Kim, Mi-Jeong (Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jung, Hae Ok (Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Jeong Rang (Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Sohn, Il Suk (Department of Cardiology, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Hyungseop (Division of Cardiology, Keimyung University Dongsan Medical Center) ;
  • Park, Seong-Mi (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Yoo, Nam Jin (Department of Internal Medicine, Wonkwang University Hospital, Institute of Wonkwang Medical Science) ;
  • Choi, Jung Hyun (Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Hyung-Kwan (Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine) ;
  • Cho, Goo-Yeong (Division of Cardiology, Department of Internal Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital) ;
  • Lee, Mi-Rae (Division of Cardiology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Jin-Sun (Department of Cardiology, Ajou University School of Medicine) ;
  • Shim, Chi Young (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Kim, Dae-Hee (Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin, Dae-Hee (Division of Cardiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Shin, Gil Ja (Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Shin, Sung Hee (Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine) ;
  • Kim, Kye Hun (Department of Cardiology, Chonnam National University Hospital) ;
  • Kim, Woo-Shik (Department of Internal Medicine, Cardiovascular Center, Kyung Hee University Medical Center) ;
  • Park, Seung Woo (Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2016.09.01
  • Accepted : 2016.11.30
  • Published : 2016.12.27
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Abstract

Background: It is important to understand the distribution of 2-dimensional strain values in normal population. We performed a multicenter trial to measure normal echocardiographic values in the Korean population. Methods: This was a substudy of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL) study. Echocardiographic specialists measured frequently used echocardiographic indices in healthy people according to a standardized method at 23 different university hospitals. The strain values were analyzed from digitally stored images. Results: Of a total of 1003 healthy participants in NORMAL study, 2-dimensional strain values were measured in 501 subjects (265 females, mean age $47{\pm}15$ years old) with echocardiographic images only by GE echocardiographic machines. Interventricular septal thickness, left ventricular (LV) posterior wall thickness, systolic and diastolic LV dimensions, and LV ejection fraction were $7.5{\pm}1.0mm$, $7.4{\pm}1.0mm$, $29.9{\pm}2.8mm$, $48.9{\pm}3.6mm$, and $62{\pm}4%$, respectively. LV longitudinal systolic strain (LS) values of apical 4-chamber (A4C) view, apical 3-chamber (A3C) view, apical 2-chamber (A2C) view, and LV global LS (LVGLS) were $-20.1{\pm}2.3$, $-19.9{\pm}2.7$, $-21.2{\pm}2.6$, and $-20.4{\pm}2.2%$, respectively. LV longitudinal systolic strain rate (LVLSR) values of the A4C view, A3C view, A2C view, and LV global LSR (LVGLSR) were $-1.18{\pm}0.18$, $-1.20{\pm}0.21$, $-1.25{\pm}0.21$, and $-1.21{\pm}0.21^{-s}$, respectively. Females had lower LVGLS ($-21.2{\pm}2.2%$ vs. $-19.5{\pm}1.9%$, p < 0.001) and LVGLSR ($-1.25{\pm}0.18^{-s}$ vs. $-1.17{\pm}0.15^{-s}$, p < 0.001) values than males. Conclusion: We measured LV longitudinal strain and strain rate values in the normal Korean population. Since considerable gender differences were observed, normal echocardiographic cutoff values should be differentially applied based on sex.

Keywords

Acknowledgement

Supported by : Korean Society of Echocardiography

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