Longitudinal fractional shortening and its relation to diastolic cardiac function.

Abstract

Although alterations in longitudinal systolic function have been considered the earliest sign of cardiac damage, the importance of longitudinal fractional shortening (LFS), which reflects left ventricular longitudinal contraction, has not been studied in detail. We introduce a new method of measuring LFS by echocardiography and evaluate its efficiency. Our study population consisted of 120 patients with diabetes mellitus (DM), 29 healthy volunteers, and 12 patients with coronary artery disease (CAD). LFS was assessed echocardiographically. Patients with DM underwent conventional echocardiography, assessment of left ventricular diastolic function, and pulsed-wave tissue Doppler study. LFS was 0.07 ± 0.02 in patients with CAD, 0.16 ± 0.05 in patients with DM, and 0.26 ± 0.04 in the normal controls. The three groups differed significantly with respect to the mean LFS values, which were significantly lower in patients with DM than in the normal controls. The ratio of peak diastolic velocities during early filling and atrial contraction (Em/Am) measured on pulsed-wave tissue Doppler images was significantly correlated with LFS (r = 0.37, P < 0.0001). LFS is correlated with diastolic cardiac function and is a useful and sensitive index for evaluating long-axis systolic function.