Background:It is well acknowledged that left ventricular (LV) contractile performance affects LV relaxation via LV elastic recoil. Accordingly, we aimed to investigate whether global longitudinal strain (GLS), particularly longitudinal strain at LV apical segments at end-systole (ALS), obtained by 2-dimensional speckle-tracking echocardiography could be used to assess LV relaxation.

Methods and Results:We enrolled 121 patients with suspected or definite coronary artery disease in whom echocardiography and diagnostic cardiac catheterization were performed on the same day. We obtained conventional echo-Doppler parameters and GLS, as well as ALS prior to catheterization. LV functional parameters were obtained from the LV pressure recorded using a catheter-tipped micromanometer. In all patients, GLS and ALS were significantly correlated with the time constant τ of LV pressure decay during isovolumetric relaxation (r=0.63 [P<0.001] and r=0.66 [P<0.001], respectively). Receiver operating characteristic curve analysis for identifying impaired LV relaxation (τ ≥48 ms) revealed that ALS greater than −22.3% was an optimal cut-off value, with 81.7% sensitivity and 82.4% specificity. Even in patients with preserved LV ejection fraction, the same ALS cut-off value enabled the identification of impaired LV relaxation with 70% sensitivity and 87.5% specificity.

Conclusions:The findings indicate that contractile dysfunction at LV apical segments slows LV relaxation via loss of LV elastic recoil, even in patients with preserved LVEF.

背景：众所周知，左心室 (LV) 收缩性能通过 LV 弹性回缩影响 LV 舒张。因此，我们旨在研究通过二维斑点追踪超声心动图获得的整体纵向应变 (GLS)，特别是 LV 心尖段在收缩末期 (ALS) 的纵向应变是否可用于评估 LV 松弛。

方法和结果：我们招募了 121 名疑似或确诊冠状动脉疾病的患者，他们在同一天进行了超声心动图检查和诊断性心导管检查。我们在导管插入术之前获得了传统的回声多普勒参数和 GLS，以及 ALS。LV 功能参数是从使用导管尖端微压计记录的 LV 压力中获得的。在所有患者中，GLS 和 ALS 与等容舒张期间 LV 压力衰减的时间常数 τ 显着相关（分别为 r=0.63 [P<0.001] 和 r=0.66 [P<0.001]）。识别 LV 舒张受损 (τ ≥ 48 ms) 的接受者操作特征曲线分析显示，大于 -22.3% 的 ALS 是最佳截止值，灵敏度为 81.7%，特异性为 82.4%。即使在左室射血分数保留的患者中，

结论：研究结果表明，即使在 LVEF 保留的患者中，LV 心尖段的收缩功能障碍也会通过 LV 弹性回缩力的丧失减缓 LV 舒张。