Arq Bras Cardiol: Imagem cardiovasc 2017; 30(2): 46-53

Diastolic Function Assessment with Doppler Echocardiography and Two-Dimensional Strain

DOI: 10.5935/2318-8219.20170012

Summary

Background

The evaluation of left ventricular (LV) diastolic dysfunction presents a significant number of indeterminate dysfunctions, especially when ejection fraction (EF) is preserved. Global longitudinal strain (GLS) and systolic strain rate (SSR) and early diastolic strain rate (EDSR) may be useful for reclassifying diagnosed patients.

Objective

To evaluate, using GLS, SSR and EDSR, patients with diastolic dysfunction, compare with healthy individuals, and determine the additive value of the method.

Methods

The study included 149 patients (age 62.2 ± 10.6) with diastolic dysfunction (49.7% grade 1; 15.4% grade 2; 18.1% grade 3 and 16.8% unspecified) and 189 healthy individuals (age 44.5 ± 13.3). Left ventricular (LV) and left atrial (LA) dimensions and function, mitral and tissue Doppler velocities and their ratios, GLS, SSR and EDSR have been determined. Data evaluation using the Kolmogorov-Smirnoff, Kruskal-Wallis tests, multiple regression analysis and area under the ROC curve. Data were considered significant when p < 0.05.

Results

In diastolic dysfunction, LV dimensions and thickness were increased and EF was lower. Mitral and tissue Doppler revealed abnormalities and LA volume and tricuspid regurgitation velocity were increased. GLS and EDSR were decreased in dysfunction grade 2 and 3 and EDSR was decreased in dysfunction grade 1, correlating better with diastolic dysfunction. The ROC cutoff value for the EDSR was 1.0 s^-1.

Conclusion

Diastolic dysfunction supplemented with myocardial strain rate seems to add sensitivity and specificity where the diastolic function is indeterminate and may be used for reclassifying these patients. (Arq Bras Cardiol: Imagem cardiovasc. 2017;30(2):46-53)