Influence of chest conformation on myocardial strain parameters in healthy subjects with mitral valve prolapse
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ORIGINAL PAPER
Influence of chest conformation on myocardial strain parameters in healthy subjects with mitral valve prolapse Andrea Sonaglioni1,4 · Gian Luigi Nicolosi2 · Michele Lombardo1 · Gian Franco Gensini1 · Giuseppe Ambrosio3 Received: 19 August 2020 / Accepted: 21 October 2020 © Springer Nature B.V. 2020
Abstract Chest shape might affect myocardial strain parameters. However, the relationship between myocardial strain parameters and chest conformation has not been previously investigated in subjects with mitral valve prolapse (MVP). Between April 2019 and May 2020, 60 healthy subjects (50.1 ± 8.6 year/old, 46.6% females) with MVP and mild-to-moderate mitral regurgitation, and 60 controls matched by age, sex, and cardiovascular risk factors were consecutively studied. Participants underwent modified Haller index (MHI) assessment (ratio of chest transverse diameter over the distance between sternum and spine), and transthoracic echocardiography implemented with 2D-speckle tracking analysis. MHI was significantly greater in MVP group than controls (2.6 ± 0.35 vs 2.1 ± 0.23, p 2.5, but not in those with MHI ≤ 2.5. MHI showed a strong inverse correlation with LV-GLS (r = − 0.85), GCS (r = − 0.84), GRS (r = − 0.84) and LV peak twist (r = − 0.94). In MVP subjects, impairment of myocardial strain parameters is not due to intrinsic reduction of cardiac contractility function, but it appears to be related to the degree of chest deformity. Keywords Mitral valve prolapse · Myocardial strain · Haller index Abbreviations 2D Two-dimensional AFI Automated function imaging A-P Antero-posterior AVC Aortic valve closure BP Blood pressure BSA Body surface area CI Confidence interval CMR Cardiovascular magnetic resonance * Andrea Sonaglioni [email protected] 1
Department of Cardiology, Ospedale San Giuseppe MultiMedica, Milan, Italy
2
Department of Cardiology, Policlinico San Giorgio, Pordenone, Italy
3
Cardiology and Cardiovascular Pathophysiology, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Perugia, Italy
4
Ospedale San Giuseppe MultiMedica IRCCS, Via San Vittore 12, 20123 Milano, Italy
DBP Diastolic blood pressure ECG Electrocardiogram GCS Global circumferential strain GLS Global longitudinal strain GRS Global radial strain HR Heart rate ICC Intraclass correlation coefficient LAVi Left atrial volume index LBBB Left bundle branch block L-L Latero-lateral LV Left ventricular LVEF Left ventricular ejection fraction LVFP Left ventricular filling pressures LVMi Left ventricular mass index MHI Modified Haller index MVP Mitral valve prolapse MR Mitral regurgitation NS-STT Nonspecific ST-segment and T-wave abnormalities PE Pectus excavatum RBBB Right bundle branch block
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ROI Region of interest RV Right ventricular RVEDD Right ventricular end-diastolic diameter RWT Relative wall thickness SBP Systolic blood pressure SPAP Systolic pulmonary artery pressure SR Strain rate STE Speckle-tracking echocardiography TAPSE Tri
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