Page 36 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou

ABSTRACT
Values for Level- (apical, mid and basal) and layer-based (endocardial, mid- myocardial and epicardial) left ventricular (LV) longitudinal strain across age are scarce. The present study evaluates the effect of aging on level- and layer- specific LV longitudinal strain in individuals without structural heart disease. A total of 408 individuals (mean age 58 (range 16-91) years; 49% men) were evaluated retrospectively. Patients were divided into equal groups based on age and gender. Individuals with evidence of structural heart disease or arrhythmias were excluded. Mean LV ejection fraction was 62 ± 6.2%. A gradual increase in magnitude of level LV longitudinal strain was observed from basal to mid and apical levels (-16.7±2.1%, -18.8±2.0%, -22.6±3.8%; p<0.001, respectively). Across age groups, there was a borderline significant decrease in magnitude of basal longitudinal strain in older individuals while the magnitude in the apical level significantly increased. On layer-based analysis, the magnitude of longitudinal strain increased from epi- to endocardium across all age groups. On multivariable analysis, only diabetes mellitus was associated with more impaired longitudinal strain in the endocardium. Whereas, male gender was associated with more impaired longitudinal strain at the epicardium layer. In conclusion, with increasing age, the magnitude of LV longitudinal strain at the basal level declines while the apical LV longitudinal strain increases. In contrast, layer-specific LV longitudinal strain remains unchanged with aging. The presence of diabetes mellitus modulated the effect of age on the LV endocardial layer whereas male gender was associated with more impaired longitudinal strain at the epicardial layer.