Normal reference values of multilayer longitudinal strain according to age decades in a healthy population: A single-centre experience

Giuseppina Novo, Vincenzo Evola, Roberta Esposito, Ciro Santoro, Francesco Lo Iudice, Regina Sorrentino, Gian Marco Alcidi, Maria Lembo, Francesco Borgia, Patrizio Lancellotti, Maurizio Galderisi, Bruno Trimarco, Francesco Lo Iudice

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34 Citations (Scopus)


Aims Recent advancements in echocardiographic technology allow to analyse myocardial strain in multiple layers. Little isknown about the impact of age on layer-specific longitudinal strain in healthy subjects. The aim of this study was toanalyse the influence of age on multilayer longitudinal strain and establish normal reference values of layer-specificstrain according to age decades in a healthy population referring to our echo laboratory using 2D speckle-trackingechocardiography with layer-specific software. Methodsand resultsTwo-hundred sixty-six healthy, consecutive subjects (mean age = 39.2 ± 17.5 years, women/men = 137/129), free ofcardiovascular risk factors, were enrolled. Subjects were divided according to six age decades: 10–19, 20–29, 30–39, 40–49, 50–59, >60 years. All subjects underwent a complete echo Doppler examination including quantitationof 2D global longitudinal strain (GLS). Subendocardial longitudinal strain (LSsubendo), subepicardial longitudinalstrain (LSsubepi), and strain gradient (LSsubendo - LSsubepi) were also determined. GLS (P < 0.001), LSsubendo,and LSsubepi (both P < 0.0001) were all progressively reduced with increasing age decades, but post hoc intra-groupanalyses demonstrated that the decline of GLS, LSsubendo, and LSsubepi was significant in the decades 50–60 and>_60 years. In separate multiple linear regression analyses, the effect of age on GLS, LSsubendo, and LSsubepiremained significant even after adjusting for clinical and echocardiographic confounders. Strain gradient remainedunchanged in age decades. Conclusion Ageing shows an independent effect on GLS, LSsubendo, and, particularly on, LSsubepi. Our data also provide normal reference values of layer-specific longitudinal strain for age decades.
Original languageEnglish
Pages (from-to)1390-1396
Number of pages7
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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