Correlation between LV regional strain and LV dyssynchrony assessed by 2D STE in patients with different levels of diastolic dysfunction

Backgrounds: Little is known about left ventricular (LV) circumferential, radial, and longitudinal functions in patients with diastolic dysfunction (DD). The aims of this study were: (1) to characterize circumferential, radial, and longitudinal strain and (2) to use 2D speckle tracking echocardiography (STE) to evaluate LV dyssynchrony in different DD grades. Methods and results: We studied 128 subjects (90 with DD, 38 healthy controls). DD was divided into three groups according to grade (group 1; mild, group 2; moderate, and group 3; severe). Regional strains were measured by 2D STE. Global LV CS was significantly lower in group 3 (-17.4 ± 5.2) compared with healthy controls (-21.2 ± 3.6), group 1 (-20.7 ± 3.9), and group 2 (-20.2 ± 4.0) (P < 0.0001 for each comparison). Global LV RS and LS were significantly lower in all three groups than in controls. Conclusion: LV, LS, and RS were lower in patients with mild to severe DD than in healthy controls. However, LV CS was similar to normal control values in patients with mild to moderate DD but was lower in patients with severe DD. Circumferential segmental LV motion is likely to compensate for impaired longitudinal and radial LV motion in patients with DD. LV dyssynchrony also occurred significantly more frequently in patients with DD with normal EF than in healthy controls. These results suggest that, in patients with DD and normal EF, contraction of the myocardium is not synchronized and that LV dyssynchrony plays a role in producing diastolic heart failure.