Normal 2-Dimensional Strain Values of the Left Ventricle: A Substudy of the Normal Echocardiographic Measurements in Korean Population Study

Abstract

BACKGROUND: It is important to understand the distribution of 2-dimensional strain values in normal population. We performed a multicenter trial to measure normal echocardiographic values in the Korean population. METHODS: This was a substudy of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL) study. Echocardiographic specialists measured frequently used echocardiographic indices in healthy people according to a standardized method at 23 different university hospitals. The strain values were analyzed from digitally stored images. RESULTS: Of a total of 1003 healthy participants in NORMAL study, 2-dimensional strain values were measured in 501 subjects (265 females, mean age 47 +/- 15 years old) with echocardiographic images only by GE echocardiographic machines. Interventricular septal thickness, left ventricular (LV) posterior wall thickness, systolic and diastolic LV dimensions, and LV ejection fraction were 7.5 +/- 1.0 mm, 7.4 +/- 1.0 mm, 29.9 +/- 2.8 mm, 48.9 +/- 3.6 mm, and 62 +/- 4%, respectively. LV longitudinal systolic strain (LS) values of apical 4-chamber (A4C) view, apical 3-chamber (A3C) view, apical 2-chamber (A2C) view, and LV global LS (LVGLS) were -20.1 +/- 2.3, -19.9 +/- 2.7, -21.2 +/- 2.6, and -20.4 +/- 2.2%, respectively. LV longitudinal systolic strain rate (LVLSR) values of the A4C view, A3C view, A2C view, and LV global LSR (LVGLSR) were -1.18 +/- 0.18, -1.20 +/- 0.21, -1.25 +/- 0.21, and -1.21 +/- 0.21(-s), respectively. Females had lower LVGLS (-21.2 +/- 2.2% vs. -19.5 +/- 1.9%, p < 0.001) and LVGLSR (-1.25 +/- 0.18(-s) vs. -1.17 +/- 0.15(-s), p < 0.001) values than males. CONCLUSION: We measured LV longitudinal strain and strain rate values in the normal Korean population. Since considerable gender differences were observed, normal echocardiographic cutoff values should be differentially applied based on sex.