Left Ventricular Longitudinal Strain Is Associated with Ascending Aortic Diameters in Healthy Adults—A Detailed Single-Center Retrospective Analysis from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Healthy Study
Aug 2026· Medicina· Vol 62· 0 citations· 26 references
Medicine
TL;DR
Even in the absence of cardiovascular pathology, a finely tuned interaction can be observed between regional LV deformation, especially with LV-LS and the size of the ascending aorta in healthy individuals.
Abstract
Background and Objectives: A more precise understanding of ventriculo–arterial coupling is essential, particularly regarding quantitative and qualitative associations can be demonstrated between the aorta and the left ventricle (LV), which is considered the engine of the central circulation. The aim of the present study was to investigate the associations between three-dimensional speckle-tracking echocardiography (3DSTE) derived unidimensional LV strains and end-systolic and end-diastolic ascending aortic diameters measured by M-mode echocardiography (MME). Additionally, the outcomes were analyzed after stratifying the parameters into below-average, average, and above-average. Materials and Methods: The present retrospective cohort study consisted of 162 healthy adult volunteers enrolled between 2011 and 2017, of which 93 participants (mean age: 30.6 ± 10.0 years; 54 males) were eligible for simultaneous 3DSTE-derived LV strain assessment and MME-based aortic dimension measurement. In all individuals, MME, two-dimensional Doppler echocardiography and 3DSTE were performed. Results: An increase in end-diastolic ascending aortic diameter (AAD) was associated with an increase in end-systolic AAD, and vice versa. At the maximum end-diastolic AAD, the basal, global, and mean segmental LV longitudinal strain (LS) values reached their lowest. When end-systolic AAD reached its maximum, both global and mean segmental LV-LS dropped to their minimum. The highest end-diastolic and end-systolic AADs were detectable in the presence of the lowest global LV-LS. With larger end-diastolic and end-systolic AADs, a trend toward higher LV radial strain was present. Conclusions: Even in the absence of cardiovascular pathology, a finely tuned interaction can be observed between regional LV deformation, especially with LV-LS and the size of the ascending aorta in healthy individuals.
There are no significant correlations between AAPSE and LV rotational parameters, but the trends observed in subgroup analyses could serve as hypothesis-generating observations for future studies.
A. Nemes, Barbara Bordács, N. Ambrus et al.· Journal of Clinical Medicine· 0 citations
Background Haemodynamic, neurohormonal, plasma volume, haematological, and structural cardiac changes occur during healthy pregnancy to varying degrees depending on the trimester. The aim of the present observational cross-sectional study was to compare left ventricle (LV) rotational mechanics in healthy pregnant subjects with those of age-matched non-pregnant women using three-dimensional speckle-tracking echocardiography (3DSTE). Methods The initial study population consisted of 27 healthy subjects in mid-term pregnancy; however, 6 cases were excluded due to suboptimal image quality. Consequently, the final analytical cohort comprised 21 subjects (mean age: 30.7±2.7 years). This group was compared to a control group of 27 age-matched healthy non-pregnant volunteers (mean age: 28.4±6.0 years). Results In three pregnant subjects, the near absence of LV rotational mechanics, referred to as rigid body rotation (RBR), was observed (3 of 21, 14%) with counterclockwise orientation. The remaining 18 subjects showed normally directed LV rotational mechanics (18 of 21, 86%). A significant reduction in apical LV rotation (4.0±3.9° vs. 9.2±3.2°, P<0.05) and LV twist (6.8±3.6° vs. 13.1±3.4°, P<0.05) could be detected in healthy pregnant women compared with non-pregnant subjects. Basal LV rotation did not differ significantly between the two groups (−3.2±2.3° vs. −3.8±1.8°, P=ns). Time to peak apical LV twist tended to be shorter in pregnant women; however, this difference did not reach statistical significance. Conclusions Reduced apical LV rotation and consequent LV twist with preserved basal LV rotation could be detected in healthy mid-term pregnancy. In some cases, counterclockwise LV-RBR was observed.
Renáta Halcsik, Tibor Novák, Á. Kormányos et al.· Quantitative Imaging in Medi...· 0 citations
Energy loss (EL) derived from vector flow mapping (VFM) is an indicator of intraventricular flow efficiency in the left ventricle. However, standardized reference values in adults have not been established. Furthermore, the clinical significance of systolic and diastolic EL assessments has not been fully explored. Therefore, we aimed to separately quantify VFM-derived EL during systole and diastole in healthy participants, and to clarify age-related differences. This single-center retrospective observational study included 41 healthy participants (young group < 65-years-old, n = 16; elderly group ≥ 65-years-old, n = 25) who underwent transthoracic echocardiography between April 2025 and April 2026. VFM was used to quantify maximum mean EL, mean systolic EL (Mean ELS), mean diastolic EL (Mean ELD), the diastolic-to-systolic EL ratio (ELD/ELS), and the ratio of the diastolic to systolic EL area under the time curve (AUCD/AUCS). In addition, EL indices normalized by stroke volume (SV), cardiac output (CO), mitral inflow velocities (E and A waves), and myocardial relaxation index (e′) were evaluated. Statistical analyses were conducted using the Shapiro–Wilk test, independent t-test, Mann–Whitney U test, and Fisher’s exact test. The maximum mean EL and Mean ELS were significantly higher in the elderly group than in the younger group, whereas no significant difference was observed in Mean ELD. In phase-based comparisons, the ELD/ELS and AUC ratios were significantly lower in the elderly group. Among the normalized EL parameters, Mean ELS/SV and Mean ELS/CO remained significantly higher in the elderly group, indicating that age-related differences in EL persisted after normalization. VFM-derived EL exhibits age-related, phase-dependent changes characterized by a selective increase in systolic EL and altered phase distribution in healthy participants. Separate assessment of systolic and diastolic EL may provide insights into left ventricular flow efficiency beyond conventional echocardiographic indices. jRCT1030250395 (Registration date: 29 September 2025).
N. Otani, Haruka Noma, H. Takahashi et al.· Cardiovascular Ultrasound· 0 citations
Introduction Left ventricular diastolic dysfunction is associated with left atrial remodeling and alterations of the pulmonary circulation. However, whether these interconnected changes across the cardiopulmonary axis can be simultaneously characterized using a non-dedicated whole-body MRI examination in individuals free of overt cardiovascular disease remains unclear. Methods 339 subjects (mean age 56.4 years; 43.4% female) without overt cardiovascular disease were included. Linear regression models, adjusted for age, sex, and cardiovascular risk factors, explored the association of Left ventricle (LV) filling rates with left atrium (LA) size and function, and mean pulmonary artery (MPA). Results Average maximal LA was 19.6 cm2, minimal LA 11.8 cm2, area-based LA function 39.8%, non-electrocardiogram-synchronized LA size 16.8 cm2, LV early filling rate 227.1 mL/s, late filling rate 238.4 mL/s, and MPA diameter 2.67 cm. Higher early and late LV filling rates were associated with larger maximal LA size across all models (β = 2.30; β = 1.00), minimal LA size (β = 1.41; β = 0.77), and non-electrocardiogram-synchronized LA size (β = 1.86; β = 0.90, all p < 0.001, fully adjusted model). Higher early LV filling rates, but not higher late LV filling rates, were associated with larger MPA diameter across all models (β = 0.06, p = 0.03, fully adjusted model). Conclusion In individuals free of overt cardiovascular disease, MRI-derived LV filling dynamics were associated with structural alterations of the left atrium and pulmonary vasculature, suggesting that changes across the cardiopulmonary axis may already be detectable by whole-body MRI before clinical disease becomes apparent.
C. Wintergerst, R. Lorbeer, Susanne Rospleszcz et al.· Frontiers in Cardiovascular...· 0 citations
Aim
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To describe the characteristics of peak myocardial strain, time-to-peak strain, and peak systolic strain rate (PSSR) at the basal, mid, and apical left ventricular (LV) levels in the longitudinal, circumferential, and radial directions in patients with amyloid cardiomyopathy (ACM) using feature-tracking cardiac magnetic resonance (FT-CMR) imaging.
Material
and methods.
This single-center observational study included 25 patients with verified ACM. Cardiac MRI was performed on 1,5 and 3,0 T scanners, acquiring shortand long-axis cine steady-state free precession (SSFP) images. Postprocessing analysis of LV strain was performed on cine SSFP images using feature tracking (CVI42, Circle Cardiovascular Imaging Inc.). Peak strain, TTP, and PSSR were assessed in the radial, circumferential, and longitudinal directions at the basal, mid, and apical LV levels. Quantitative values are presented as M±SD.
R
e
sults
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Peak longitudinal strain progressively increased in absolute value from basal to apical segments as follows: -1,02±9,55% (basal) ® -8,47±5,69% (mid) ® -12,18±3,01% (apical), consistent with a pattern of comparatively preserved apical longitudinal strain. The peak circumferential strain also increased from basal to apical segments as follows: -14,47±2,89% ® -15,73±3,50% ®-18,42±4,69%. The peak radial strain was highly variable as follows: 60,00±33,11% (basal), 25,69±13,37% (mid), and 50,86±37,97% (apical). The mean TTP was highest at the apical level for all following directions: radial 357,11±114,83 ms; circumferential 391,97±62,42 ms; longitudinal 394,52±63,25 ms. Longitudinal PSSR was -0,86±2,18; -0,96±0,95 and -0,85±0,40 1/s (basal, mid, apical), while circumferential PSSR — -0,91±0,28; -0,94±0,18 and –1,18±0,88 1/s, and radial PSSR — 7,48±10,30; 2,19±1,72 and 6,74±7,86 1/s.
Conclusion
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In patients with ACM, FT-CMR reveals a characteristic peak strain gradient with relative preservation of apical segments in the longitudinal direction, TTP prolongation in the apical segments in all directions, and directionally variable PSSR values. Comprehensive segmental FT-CMR assessment of strain, TTP, and PSSR can serve as an additional noninvasive tool for characterizing LV mechanics in amyloid lesions.
S. R. Sheriev, V. Fokin, A. V. Ryzhkov et al.· Russian Journal of Cardiolog...· 0 citations
Routine clinical practice, standard echocardiographic measurements showed overall good reproducibility, with the strongest performance for left ventricular indices.
Raúl Reyes-Toledo, D. G. David-Pardo, G. Lemus-Barrios et al.· Frontiers in Cardiovascular...· 0 citations
