Over all variability of mitral annular plane peak systolic velocity and peak global longitudinal strain rate in relation to age, body size, and sex: The HUNT Study

Abstract

Background: Left ventricular (LV) systolic global function can be assessed by peak annular systolic velocity S′. Global longitudinal strain rate (GLSR) is relative LV shortening rate, equivalent to normalizing S′ for LV length (S′n). It has previously been shown that mitral annular plane systolic excursion (MAPSE) and global longitudinal strain (GLS) have similar biological variability, but GLS normalizes for one dimension only, inducing a systematic error, increasing body size dependence. The objective of this study was to compare S′ with GLSR in the same way, comparing biological variability and body size dependence. Methods and Results: A total of 1266 subjects from the third wave of Nord-Trøndelag Health Study (HUNT), without evidence of heart disease, were examined. Strain rate, S′ and wall lengths were measured in the four walls of the two- and four-chamber views. Mean S′ was 8.4 (1.4) cm/s, (S′n) was 0.7 (0.14)s−1 and GLSR 1.02 (0.14)s−1. All measures declined with age. Normalization of mitral annular velocities for LV length, or the use of GLSR, did not reduce overall biological variability compared with S′. S′ did show a weak, positive correlation to BSA, while S′n and GLSR a slightly stronger, negative correlation to BSA. Conclusions: S′, S′n, and GLSR have similar biological variability, which is mainly due to age, not body size variation. Normalizing S′ for LV length (as in Sn or GLSR) reverses correlation with BSA inducing a systematic error, due to the one-dimensional normalization for one dimension only.