Abstract
Objective: The objective was to evaluate the normal value of left ventricular myocardial strain using the computed tomography feature-tracking technique and to explore the correlation between myocardial strains and cardiac function parameters. Methods: Participants suspected of coronary heart disease were selected from 17 August 2020 to 5 November 2020 to undergo coronary computed tomography angiography using a third-generation dual-source CT scanner. Data were imported into a commercial software (Medis) after multiphase reconstruction. The cardiac function parameters, radial (Err), circumferential (Ecc), and longitudinal strain (Ell) of the left ventricle were recorded. Results: A total of 87 normal subjects were enrolled, including 41 males and 46 females. For healthy subjects, the global radial strain (GRS), circumferential strain (GCS), and longitudinal strain (GLS) of the left ventricle were 74.5 ± 15.2%, −22.7 ± 3.0%, and −26.6 ± 3.2%, respectively. The Err and Ecc absolute values (|Ecc|) were the largest at the apex, and the |Ell| gradually increased from the base to the apex. The Err and |Ecc| were the largest in the lateral and inferior wall, respectively. |Ell| showed a clockwise decrease from the lateral wall in the short axis. Meanwhile, the GRS and |GLS| in females were higher than that in males. Multiple linear regression analysis showed that both SV and LVEF were the independent determinants of GRS, GCS, and GLS. BMI and CO were the independent determined factors of GCS. Conclusions: At a reasonable radiation dose, CT feature-tracking is a feasible and reproducible method to analyze left ventricular myocardial strain. Left ventricular myocardial strain in normal subjects varies in gender, segments, levels, and regions.
Highlights
Myocardial strain is defined as heart deformation during the systolic process, including radial strain (Err), circumferential strain (Ecc), and longitudinal strain (Ell) [1]
There was no significant difference in the global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) among all age groups (Figure 6)
The GRS of the left ventricle was significantly negatively correlated with left ventricular end-systolic volume (LVESV) (r = −0.256, p < 0.05) and significantly positively correlated with left ventricular ejection fraction (LVEF) (r = 0.632, p < 0.01)
Summary
Myocardial strain is defined as heart deformation during the systolic process, including radial strain (Err), circumferential strain (Ecc), and longitudinal strain (Ell) [1]. Common methods to evaluate the systolic function include speckle-tracking imaging ultrasound and feature-tracking based on cardiac magnetic resonance imaging (FT-CMR). Computed tomography imaging (CT) is a rapid, convenient way to provides a one-stop evaluation of cardiac function when assessing coronary artery anatomy and is more standardized than US. Feature-tracking based on computed tomography (FT-CT) is an excellent way to assess cardiac function and is consistent with US and CMR [5,6,7]. Many studies [3,8,9,10] have shown normal values of the left ventricular myocardial strain by US and CMR, whereas using FT-CT to evaluate the strain of the left ventricular myocardium in healthy subjects has rarely been reported
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