5 key points
- Normal value for global longitudinal strain±
- Reported normal values of GLS varies from -15.9% to -22.1% (mean, -19.7%; 95% CI, -20.4% to -18.9%).
- Normal global circumferential strain varies from -20.9% to -27.8% (mean, -23.3%; 95% CI, -24.6% to -22.1%).
- Global radial strain ranges from 35.1% to 59.0% (mean, 47.3%; 95% CI, 43.6% to 51.0%).
- Variability in reapeted measurments in GLS±
- Interobserver relative mean errors are 5.4% to 8.6%
- Intraobserver relative mean errors are 4.9% to 7.3%
- Differences between vendors are small (approximaletely 3.7% strain units) but should nevertheless be taken into account. I reccommend using a single vendor for longitudinal follow up in individual patients
- In contrast to GLS, LV segmental longitudinal strain shows a higher variability on top of the known intervendor bias. The compariability of different software to follow segmental function varies considerably.
- Several clinical factors influence ragional and global strain values:
- Age (lower deformation values in patients >60y)
- Sex (lower deformation values in men)
- Blood pressure (increase in blood pressure results in lower defromation values)
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- Mirea O, Pagourelias ED, Duchenne J, Bogaert J, Thomas JD, Badano LP, Voigt JU; EACVI-ASE-Industry Standardization Task Force. Variability and Reproducibility of Segmental Longitudinal Strain Measurement: A Report From the EACVI-ASE Strain Standardization Task Force. JACC Cardiovasc Imaging. 2018 Jan;11(1):15-24.
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- Teske AJ, De Boeck BW, Olimulder M, Prakken NH, Doevendans PA, Cramer MJ. Echocardiographic assessment of regional right ventricular function: a head-to-head comparison between 2-dimensional and tissue Doppler-derived strain analysis. J Am Soc Echocardiogr. 2008 Mar;21(3):275-83.