Quantitative evaluation of longitudinal strain in layer-specific myocardium during normal pregnancy in ChinaReport as inadecuate




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Cardiovascular Ultrasound

, 14:45

First Online: 10 November 2016Received: 03 October 2016Accepted: 02 November 2016

Abstract

BackgroundThe myocardial wall of the left ventricle is a complex, multilayered structure and is not homogenous. The aim of this study was to determine longitudinal strain LS in the three myocardial layers in normal pregnant women according to gestation proceedings.

MethodsThe advanced two-dimensional speckle tracking echocardiography 2D STE was performed on 62 women during each pregnancy trimester and 6 to 9 weeks after delivery, while 30 age-matched, healthy, nonpregnant women served as controls. LS on endocardial, mid-myocardial and epicardial layers at 18 cardiac segments were measured.

ResultsAs gestation proceeded, all of layer-specific LS and global LS progressively decreased, which subsequently recovered postpartum P < 0.05, and the LS gradient between inner and outer myocardium became greater, which reached its maximum in the late pregnancy. Peak systolic LS was the highest at endocardium and the lowest at epicardium, while the highest at the apical level and the lowest at the base P < 0.05. In the early pregnancy and postpartum, LS at basal level was homogenous, meanwhile layer-specific LS showed significant differences at mid-ventricular and apical level throughout the progress of normal pregnancy P < 0.05.

ConclusionsUsing 2D STE, three-layer assessment of LS can be performed in pregnant women and shall give us new insights into the quantitative analysis of global and regional LV function during pregnancy. Future studies on the detection of pregnancy related heart disease would require these parameters as reference values for each time point of a normal pregnancy.

KeywordsPregnancy Myocardium Layer Strain Speckle-tracking Abbreviations2DTwo-dimensional

AmThe average of late diastolic velocities at mitral annulus

EmThe average of early diastolic velocities at mitral annulus

GLSGlobal longitudinal strain

GLS-endoGlobal longitudinal strain in the endocardial layer

GLS-epiGlobal longitudinal strain in the epicardial layer

GLS-midGlobal longitudinal strain in the mid-myocardial layer

IVSdInterventricular septum diameter

LSLongitudinal strain

LVLeft ventricle

LVEDdLeft ventricular end-diastolic diameter

PWdPosterior wall diameter

RWTRelative wall thickness

SmThe average of peak systolic velocities at mitral annulus

STESpeckle tracking echocardiography.

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Author: Juan Cong - Zhibin Wang - Hong Jin - Wugang Wang - Kun Gong - Yuanyuan Meng - Yong Lee

Source: https://link.springer.com/article/10.1186/s12947-016-0089-9







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