Assessing Global and Regional Left Ventricular Myocardial Function in Elderly Patients Using the Bidimensional Strain Method

Unlabelled: Biological and anatomical alterations in the elderly result in modifications of the myocardial deformation detected previously by magnetic resonance imaging (MRI) technology and could have consequences on speckle tracking's parameters in this patient population.

Aim: To compare left ventricular (LV) 2D strain between elderly patients and young individuals without heart disease.

Population And Methods: Patients without history of cardiac disease were enrolled from the geriatric department. After echocardiographic examination, exclusion criteria were LV myocardial abnormality, valve disease, and atrial fibrillation. The control group consisted of healthy subjects from the medical staff. 2D strain values were obtained from 16 segments in four-, three-, and two-chamber apical views for longitudinal and transversal strains, and from six basal segments in short-axis view for circumferential strain.

Results: Forty-five elderly patients (35 females) with mean age of 83.4±5.0 years (75-95 years) and 45 young subjects (28 females) with mean age of 33.6±7.5 years (17-45 years) were assessed. There was no difference between the two groups considering LV ejection fraction (66±6% vs. 65±4%, P=ns). Feasibility of segmental 2D strain was 55.6% for circumferential strain, 63% for transversal strain, and 82% for longitudinal strain. Global longitudinal strain was significantly lower in elderly patients (-20.9±1.9% vs. -22.2±2.2%, P<0.01). There was no significant difference in global transversal and circumferential strain.

Conclusion: Aging results in a decrease in global longitudinal strain. This should be taken into account in the assessment of pathological myocardial dysfunction.