Gender Based Variance in Tissue Velocity Does Not Reflect Differences in Myocardial Deformation

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significantly higher baseline strain/WS ratio (−0.20± 0.1 versus −0.28± 0.1, P= 0.02) compared to the tertile who deteriorated (deformation decrease of 6.9± 5.4%). EndsystolicWSwas similar betweengroups (58.8± 18.7 versus 66.2± 23.4 dynes/cm2, P= 0.28). Conclusion: Inappropriately low tissue deformation for the level of end-systolic wall stress is associated with progression of myocardial dysfunction in treated hypertensive patients. Strain/wall stress relationships may aid in prognostication in these patients. doi:10.1016/j.hlc.2007.06.107 103 Tissue Deformation is Associated with LV Geometry in Hypertensive Patients J.L. Hare ∗, M. Bansal, J.K. Brown, T.H. Marwick University of Queensland, Brisbane, Australia Background:Different patterns of abnormal LV geometry are associatedwith variations inprognosis, but themechanisms of these effects remain undefined. We investigated the functional associations of these findings using measures of tissue deformation, specifically strain and strain rate (SR). Methods: 2D echocardiography in 60 unselected hypertensive patients (age 58± 12 years, 52% male). LV mass 104 Gender Based Variance in Tissue Velocity Does Not Reflect Differences in Myocardial Deformation D.J. Holland1,2,∗, J.E. Sharman1,2, R.L. Leano1, T.H. Marwick1 1Department of Medicine, University of Queensland, Brisbane 4102, Australia; 2 School of Human Movement Studies, University of Queensland, Princess Alexandra Hospital, Brisbane 4102, Australia Background: Reports regarding the impact of gender on myocardial velocity and deformation are inconsistent. In this study, we sought the mechanism of the effect of gender on Doppler indices of left ventricular (LV) function in healthy individuals and patients with type 2 diabetes mellitus. Methods: LV deformation (strain and strain rate), systolic (Sm) and diastolic (Em) tissue velocities weremeasured in thebasal septumby tissueDoppler in a total of 276patients (148 men; aged 54± 11 years). All subjects had preserved systolic function, normal stress echo and had no history of coronary artery disease. Results: Sm was significantly higher in men compared to women (5.5± 1.10 versus 4.8± 1.15; p< 0.001) however Em, Strain and Strain Rate were not significantly different betweengenders.Onmultiple regression analysis, gender index (LVMI) and regional wall thickness were used to assign into groups with normal geometry (NG), concentric remodelling (CR), concentric hypertrophy (CH) and eccentric hypertrophy (EH). Strain/SRwasmeasured from basal septum in the apical four chamber view using velocity vector imaging (VVI, Siemens, Erlangen, Germany). Results: VVI was feasible in 57 studies (95%). Analysis of LV geometry revealed NG in 10 patients (17%), CR in 15 (25%), CH in 28 (47%) and EH in 7 (11%). Overall strain was −14.0± 4.8 % and SR was −0.73± 0.70 /s. Strain was significantly lower in patients with CR (−13.1± 4.1 %) or CH (−12.3± 4.3 %), compared to patients with NG (−18.5± 5.5 %, P≤ 0.05). Results were independent of blood pressure (MAP 113± 15mmHg), with no significant differences between groups (P= 0.29). SR was non-significantly reduced in patients with CR and CH (−0.64± 0.25 /s, −0.56± 0.19 /s) compared to NG (−0.85± 0.33 /s, P=NS), but significantly lower in patients withCHversus patientswith EH (−1.40± 1.86 /s, P≤ 0.05). Conclusions: Tissue deformation is related to LV geometry, independent of BP, in treated hypertensive patients. doi:10.1016/j.hlc.2007.06.108 was identified as themost significant independent predictorofSm(β = 0.23;p= 0.001), and remainedsignificant after correcting for body mass index (BMI), age, mean arterial pressure, LV mass and LV end diastolic and end systolic volumes. Inclusion of central hemodynamics such as augmentation index (AIx) and central systolic blood pressure had no effect on the significance of gender in the model. BMI, end diastolic volume (EDV) and end systolic volume (ESV) were also significant predictors in the model. Conclusions: Men have significantly higher LV systolic tissue velocity than women, independent of differences in myocardial deformation measured by strain and strain rate. Male (n= 148) Female (n= 129) p-value Sm (cm/s) 5.4 ± 1.1 4.8 ± 1.2 <0.001 Strain (%) 20.5 ± 3.7 20.7 ± 3.5 NS SR (/s) 1.31 ± 0.37 1.29 ± 0.25 NS EDV (mL) 83 ± 20 60 ± 14 <0.001 ESV (mL) 32 ± 9 22 ± 7 <0.001 doi:10.1016/j.hlc.2007.06.109