Moderated Posters session * Insights into the use of contrast stress echocardiography and 3D strain: 14/12/2013, 08:30-12:30 * Location: Moderated Poster area

Background: Differences in definitions and measurements of parameters describing left ventricular (LV) mechanics among vendors hamper the use of 3D deformation analysis for clinical and research purposes. Our aim was to identify the reference values for 3D LV function parameters using a vendor-independent DICOM-based software. Methods: In 235 healthy volunteers uniformly distributed across decades (44±14 years, range 18–76 years), 3D LV full volume data sets (35±6 vps) were acquired using a GE Vivid E9 scanner. Exclusion criteria were athletic training, pregnancy, body mass index > 30 kg/m2, and poor apical acoustic window. LV 3D parameters (including ejection fraction, strain parameters, systolic dyssynchrony index - SDI, twist and torsion) were analyzed offline using 4D LV Analysis software 3.1 (TomTec, D). Results: Physiologic ageing was associated with a significant increase in LV ejection fraction and torsion, LV circumferential and 3D strain, and with a less synchronous regional LV function (p<0.0001 for all, except p=0.01 for torsion). Women had higher LV ejection fractions and absolute values of longitudinal and 3D strain than men (Table), but also smaller LVs (EDV 55±9 vs 64±11 ml/m2) and lower blood pressure values (SBP 114±14 vs 128±13 mmHg, p<0.0001). LV torsional mechanics (twist 7.7 vs 6.4°, torsion 0.91 vs 0.83°/cm, p=NS) and synchronicity (SDI 5.2±1.3 vs 5.2±1.3%) were similar between genders. LV deformation also showed significant regional variations, strain values in LV basal region being significantly lower than in mid or apical regions (p<0.001 for all strains). Conclusions: This study is the first to report age- and gender-specific normative values for global LV systolic function and deformation assessed by a vendor-independent software. Our data may foster the use of 3DE for assessing LV myocardial function in multi-vendor echo labs.<cross-ref type="tbl" refid="CHAPTERsub51156TB1"></cross-ref> <tbl id="CHAPTERsub51156TB1" loc="float"><tblbdy top-stubs="1"><r><c cspan="1" rspan="1"></c><c cspan="1" rspan="1">Men (n=104)</c><c cspan="1" rspan="1">Women (n=133)</c><c cspan="1" rspan="1">p</c></r><r><c cspan="1" rspan="1">Age (years)</c><c cspan="1" rspan="1">44±15</c><c cspan="1" rspan="1">44±14</c><c cspan="1" rspan="1">0.87</c></r><r><c cspan="1" rspan="1">Heart rate (bpm)</c><c cspan="1" rspan="1">67±10</c><c cspan="1" rspan="1">68±10</c><c cspan="1" rspan="1">0.28</c></r><r><c cspan="1" rspan="1">Ejection fraction (%)</c><c cspan="1" rspan="1">62±4</c><c cspan="1" rspan="1">64±3</c><c cspan="1" rspan="1"><0.0001</c></r><r><c cspan="1" rspan="1">Global longitudinal strain (%)</c><c cspan="1" rspan="1">−21.4±2.5</c><c cspan="1" rspan="1">−22.2±2.5</c><c cspan="1" rspan="1">0.02</c></r><r><c cspan="1" rspan="1">Global circumferential strain (%)</c><c cspan="1" rspan="1">−33.7±3.2</c><c cspan="1" rspan="1">−34.4±3.3</c><c cspan="1" rspan="1">0.11</c></r><r><c cspan="1" rspan="1">Global 3D strain (%)</c><c cspan="1" rspan="1">−36.7±2.9</c><c cspan="1" rspan="1">−37.5±3.9</c><c cspan="1" rspan="1">0.03</c></r></tblbdy></tbl>