Dispersion of regional longitudinal strain and strain rate in nonischemic left ventricular segments: insights from speckle tracking Dobutamine Stress Echocardiography (DSE)

Abstract

Background: The measurement of deformation parameters - Strain (S) and Strain Rate (SR) - allows the quantitative analysis of myocardial function. There is still a paucity of data concerning regional deformation during Dobutamine Stress Echocardiography (DSE) and little is known about potential differences of basal, midventricular and apical segments of the Left Ventricle (LV). Aim: Our aim was to assess regional values of longitudinal S and SR in 18 segments of LV during baseline and peak stage of DSE and change of these parameters between baseline and peak using Speckle Tracking Echocardiographic quantification (STE) and Automated Function Imaging (AFI). Methods: 238 patients were examined by DSE with acquisition of high temporal resolution data. The whole group had the coronary anatomy status established by angiography or computed tomography. A subset of 111 patients without significant coronary lesions was selected for this analysis: 68 female, mean age 60±10 years. Results: The significant dispersion of strain values among the LV segments (measured both by AFI and STE and confirmed by ANOVA, p<0.0001) was observed during baseline and peak stage of DSE. The comparison of changes in strain between peak and baseline stage showed reduction in strain amplitude of basal and mid-ventricular segments and increased amplitude of strain in apical segments of the LV. Contrarily, absolute values of SR increased during DSE in all segments. Dispersion of the change in strain and designation of segments are presented in Figure. ![Figure][1] Conclusions: We observed opposite direction of the longitudinal strain changes during DSE between apical and basal 2/3 part of myocardium. This significant dispersion among nonischemic LV segments must be considered in LV function quantification during stress echo. [1]: pending:yes