Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study. 2016

Jae-Hyeong Park, and Ju-Hee Lee, and Sang Yeub Lee, and Jin-Oh Choi, and Mi-Seung Shin, and Mi-Jeong Kim, and Hae Ok Jung, and Jeong Rang Park, and Il Suk Sohn, and Hyungseop Kim, and Seong-Mi Park, and Nam Jin Yoo, and Jung Hyun Choi, and Hyung-Kwan Kim, and Goo-Yeong Cho, and Mi-Rae Lee, and Jin-Sun Park, and Chi Young Shim, and Dae-Hee Kim, and Dae-Hee Shin, and Gil Ja Shin, and Sung Hee Shin, and Kye Hun Kim, and Woo-Shik Kim, and Seung Woo Park
Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.

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 ± 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 ± 1.0 mm, 7.4 ± 1.0 mm, 29.9 ± 2.8 mm, 48.9 ± 3.6 mm, and 62 ± 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 ± 2.3, -19.9 ± 2.7, -21.2 ± 2.6, and -20.4 ± 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 ± 0.18, -1.20 ± 0.21, -1.25 ± 0.21, and -1.21 ± 0.21-s, respectively. Females had lower LVGLS (-21.2 ± 2.2% vs. -19.5 ± 1.9%, p < 0.001) and LVGLSR (-1.25 ± 0.18-s vs. -1.17 ± 0.15-s, p < 0.001) values than males. CONCLUSIONS 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.

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