The functional role of longitudinal, circumferential, and radial myocardial deformation for regulating the early impairment of left ventricular contraction and relaxation in patients with cardiovascular risk factors: a study with two-dimensional strain imaging.

TLDR: LV myocardial contraction and relaxation were first impaired in the longitudinal direction among the 3 directions in subclinical patients with cardiovascular risk factors, however, LV pump function and LV filling were compensated by circumferential shortening at ventricular systole and 3 directional lengthenings at atrial systoles.

Abstract: Background Two-dimensional strain imaging allows rapid and accurate analysis of regional left ventricular (LV) systolic and diastolic mechanics in the longitudinal, radial, and circumferential directions. The aim of this study was to assess precisely the differences in early impairment of LV myocardial contraction and relaxation among the 3 directions in 70 patients with cardiovascular risk factors and preserved LV pump function. Methods The patients were classified into 2 groups according to the ratio of early diastolic to atrial systolic velocity (E/A) of transmitral flow: E/A ≥ 1 (n = 35, 57 ± 6.8 years) or E/A Results The mean peak systolic longitudinal strain and strain rate were lower, whereas the mean peak systolic circumferential strain and strain rate were greater in the E/A Conclusion LV myocardial contraction and relaxation were first impaired in the longitudinal direction among the 3 directions in subclinical patients with cardiovascular risk factors. However, LV pump function and LV filling were compensated by circumferential shortening at ventricular systole and 3 directional lengthenings at atrial systole, respectively.