Systolic Long Axis Function of the Left Ventricle, as Assessed by 2-D Strain, is Reduced in the Patients Who Have Diastolic Dysfunction and a Normal Ejection Fraction

Background and Objectives: Echocardiographic evaluation of the long axis left ventricle (LV) function has been reported to be useful for understanding heart failure in those patients with a preserved ejection fraction (EF). The global and segmental peak LV systolic longitudinal strain (PSLS), as determined by the 2D speckle tracking method, may be related with the conventional diastolic parameters. We sought to determine whether the PSLS could reveal LV systolic dysfunction in those patients who have a normal EF and diastolic dysfunction. Subjects and Methods: A total of 168 patients who underwent a routine echocardiographic examination were evaluated. Echocardiographic evaluations were performed and the patients were grouped according to the grade of their diastolic dysfunction. The global and segmental PSLS were analyzed off-line. Results: Measurements of the LV PSLS were successfully obtained in 83% of the patients. The mid and basal PSLS values were significantly lower in the patients with grade I and II diastolic dysfunction (-17.5±2.0% and -17.5±2.3%, respectively) versus the normal healthy controls (-20.6±1.9%, p<0.001). The mid and basal PSLS values were found to be well related to the early diastolic mitral annular velocity (r=0.510, p<0.001) and the left atrial volume index (r=-0.422, p<0.001). Conclusion: The systolic LV long-axis function, as determined by 2D strain and especially in the mid and basal LV segments, is reduced in the patients with diastolic dysfunction in spite of their normal LV EF. (Korean Circ J 2008;38:250-256)