Jacob Christensen, Kristoffer Grundtvig Skaarup, Mats Christian Højbjerg Lassen, Niklas Dyrby Johansen, Magnus Thorsten Jensen, Gorm Boje Jensen, Peter Schnohr, Rasmus Møgelvang, T B S Tor Biering-Sorensen
BACKGROUND: Left ventricular (LV) strain rates assessed by two-dimensional speckle-tracking echocardiography have exhibited clinical and prognostic significance but remain sparsely used. OBJECTIVES: We sought to establish age and sex-based normative values of LV strain rates and to assess the prognostic yield of lower limits of normality (LLN). METHODS: LV strain rate parameters included global systolic strain rate (GSRs), global early diastolic strain rate (GSRe) and global late diastolic strain rate (GSRa). The primary population consisted of healthy participants free of risk factors from the Copenhagen City Heart Study. The prognostic yield of LLN was assessed against a composite endpoint of cardiovascular death, incident heart failure and acute myocardial infarction using Cox regression in a secondary validation population, regardless of health status. RESULTS: (0.60, 0.93) for GSRa. Normative values were determined according to sex and four age intervals. All three parameters differed across sexes, while GSRs was negatively correlated with heart rate; GSRe and GSRa were negatively and positively correlated with age, respectively. GSRa below the sex- and age-appropriate LLN was independently associated with a higher risk of the composite outcome. CONCLUSION: This is the largest study to report sex- and age-specific normal values for LV strain rates. The LLNs identified, namely for GSRa, provided independent prognostic information regarding adverse cardiovascular events.