PP.14.13] THE NATURAL HISTORY OF LEFT VENTRICULAR LONGITUDINAL STRAIN IN A GENERAL POPULATION

Abstract

Objective: Recent studies demonstrated an independent prognostic role of left ventricular (LV) global longitudinal deformation (strain; LS) in patients and population. However, there are few data on changes in LS over time in the general population. We, therefore, investigated in the population cohort clinical correlates of longitudinal changes in LV end-systolic LS analyzed as continuous measures. In addition, we explored the potential impact of reduced LS on LV volumes. Design and method: We measured LV end-systolic (ESV) and end-diastolic (EDV) volumes by conventional echocardiography and global, basal-mid and apical LS by 2D speckle tracking in 627 participants (mean age 50.7 years, 51.4% women; 41.3% hypertensives) at baseline and after 4.7 years. In our analyses we used the absolute values of LS (magnitude of end-systolic deformation). Results: At baseline, means (±SD) of global, basal-mid and apical LS were 19.7 ± 2.4%, 18.5 ± 2.3% and 23.5 ± 4.2%, respectively. Over follow-up, the 5th to 95th percentile of change in global, basal-mid and apical LS were −3.9% to 3.7%, −3.2% to 3.8% and −8.8% to 5.9%, respectively. In stepwise regression, the magnitude of decrease in global, basal-mid and apical LS over time was greater in men than in women (P < 0.0001). Higher baseline mean blood pressure (MBP) as well as an increased MBP during follow-up were related to larger decreases in global as well as in level-specific LS. An increase in apical LS was significantly correlated with baseline age and change in pulse pressure over time. Furthermore, in the multivariable-adjusted analysis, we observed the significant inverse correlation between baseline ESV and global LS (P < 0.0001). Similarly, lower baseline global LS and a decreased LS over follow-up were significant predictors of longitudinal increase in ESV during follow-up (P < 0.0001 for both). No significant associations have been found between EDV and global LS measured at baseline and follow-up. Conclusions: The key findings of this study are that significant decrease in LS over time was associated with male sex, higher baseline MBP and an increase in MBP. Moreover, alteration in global LS leads to increase in LV systolic volume, which might be an early sign of adverse LV remodelling.