Factores clínico-demográficos asociados al miedo-evitación en sujetos con lumbalgia crónica inespecífica en atención primaria: análisis secundario de estudio de intervención / Clinical-demographic factors associated with fear-avoidance in subjects with non-specific chronic low back pain in Primary Care: secondary analysis of intervention study

Objetivo: Describir algunas características sociodemográficas y clínicas de los sujetos con lumbalgia crónica inespecífica (LCI) atendidos habitualmente en atención primaria (AP), así como investigar su asociación con el miedo-evitación (ME). Diseño: Descriptivo transversal. Análisis secundario de estudio de intervención. Emplazamiento: Zonas Básicas de Salud del Distrito Sanitario de AP Costa del Sol (Málaga). Participantes: Un total de 147 sujetos con LCI extraídos de la base de datos de un estudio de intervención previo en fisioterapia de AP. Características: edad, 18-65 años; comprensión del idioma español; ausencia de deterioro cognitivo, ausencia de fibromialgia, ausencia de cirugía dorsolumbar, y tolerancia al ejercicio físico. Mediciones principales: La variable principal fue el ME (FABQ y subescalas FABQ-PA y FABQ-W); las variables clínicas incluyeron: dolor (NRPS-11), discapacidad (RMQ), tiempo de evolución, tratamientos previos y diagnósticos de imagen; las variables sociodemográficas incluyeron: sexo, edad, nivel educativo y situación laboral. Resultados. El 51,7% de los sujetos presentaron elevado ME con la escala FABQ-PA. Incapacidad temporal (IT) [Beta = 24,45 (p = 0,009*); Beta =13,03 (p = 0,016*); Beta =14,04 (p = 0,011*) para FABQ, FABQ-PA y FABQ-W, respectivamente]; estudios primarios [Beta =15,09 (p = 0,01*); Beta = 9,73 (p = 0,01*) para FABQ y FABQ-PA], y discapacidad [Beta =1,45 (p < 0,001); Beta = 0,61 (p < 0,001); Beta =0,68 (p < 0,001) para FABQ, FABQ-PA y FABQ-W, respectivamente] aparecieron asociados al ME cuando fueron modelados por regresión multivariante. Conclusiones: Algunos rasgos sociodemográficos y clínicos de la población con LCI son presentados. Las pruebas de imagen (81,63%) y los tratamientos previos pasivos (55,78%) podrían reflejar problemas de adherencia a las recomendaciones de las GPC. IT, estudios primarios y discapacidad se asociaron al ME. Los hallazgos deben ser interpretados a la luz de las posibles limitaciones. Algunas sugerencias para la práctica clínica son aportadas

Objective: To describe some sociodemographics and clinical characteristics of subjects with Non-specific Chronic Low Back Pain (NCLBP) in Primary Care, as well as to investigate their association with Fear-Avoidance (FA). Design: Cross-sectional. Secondary analysis of an intervention study. Location: Basic Health Areas in Costa del Sol Health District (Málaga, Spain). Participants: An analysis was performed on 147 subjects with NCLBP from a previous intervention study database in Primary Care Physiotherapy (PCP). Characteristics: age 18-65; understanding of the Spanish language; absence of cognitive disorders, fibromyalgia or dorsolumbar surgery, and to be able to perform physical exercise. Main measurements: The main variable was FA level (FABQ and the FABQ-PA and FABQ-W) sub-scales. Clinical variables included: pain (NRPS-11), disability (RMQ), evolution, previous treatments and diagnostic imaging. The sociodemographic variables included: gender, age, educational level, and employment status. Results: Just over half (51.7%) of the subjects had high FA on the FABQ-PA sub-scale. Sick leave (SL) [Beta = 24.45 (P = .009*); Beta = 13.03 (P = .016*); Beta = 14.04 (P =.011*) for FABQ, FABQ-PA and FABQ-W, respectively]; primary studies level [Beta = 15.09 (P = .01*); Beta = 9.73 (P = .01*) for FABQ and FABQ-PA], and disability [Beta = 1.45 (P < .001); Beta = 0.61 (P < .001); Beta = 0.68 (P < .001) for FABQ, FABQ-PA and FABQ-W, respectively] were associated with FA when they were modeled by multivariate regression. Conclusions: Some sociodemographic and clinical features of the NCLBP population are presented. Imaging tests (81.63%) and previous passive treatments (55.78%) could reflect problems of adherence to recommendations of CPGs. Sick leave, primary studies level, and disability were associated with FA. The findings should be interpreted in the light of possible limitations. Some suggestions for clinical practice are provided

[Clinical-demographic factors associated with fear-avoidance in subjects with non-specific chronic low back pain in Primary Care: secondary analysis of intervention study]. / Factores clínico-demográficos asociados al miedo-evitación en sujetos con lumbalgia crónica inespecífica en atención primaria: análisis secundario de estudio de intervención.

OBJECTIVE: To describe some sociodemographics and clinical characteristics of subjects with Non-specific Chronic Low Back Pain (NCLBP) in Primary Care, as well as to investigate their association with Fear-Avoidance (FA). DESIGN: Cross-sectional. Secondary analysis of an intervention study. LOCATION: Basic Health Areas in Costa del Sol Health District (Málaga, Spain). PARTICIPANTS: An analysis was performed on 147 subjects with NCLBP from a previous intervention study database in Primary Care Physiotherapy (PCP). Characteristics: age 18-65; understanding of the Spanish language; absence of cognitive disorders, fibromyalgia or dorsolumbar surgery, and to be able to perform physical exercise. MAIN MEASUREMENTS: The main variable was FA level (FABQ and the FABQ-PA and FABQ-W) sub-scales. Clinical variables included: pain (NRPS-11), disability (RMQ), evolution, previous treatments and diagnostic imaging. The sociodemographic variables included: gender, age, educational level, and employment status. RESULTS: Just over half (51.7%) of the subjects had high FA on the FABQ-PA sub-scale. Sick leave (SL) [ß=24.45 (P=.009*); ß=13.03 (P=.016*); ß=14.04 (P=.011*) for FABQ, FABQ-PA and FABQ-W, respectively]; primary studies level [ß=15.09 (P=.01*); ß=9.73 (P=.01*) for FABQ and FABQ-PA], and disability [ß=1.45 (P<.001); ß=0.61 (P<.001); ß=0.68 (P<.001) for FABQ, FABQ-PA and FABQ-W, respectively] were associated with FA when they were modeled by multivariate regression. CONCLUSIONS: Some sociodemographic and clinical features of the NCLBP population are presented. Imaging tests (81.63%) and previous passive treatments (55.78%) could reflect problems of adherence to recommendations of CPGs. Sick leave, primary studies level, and disability were associated with FA. The findings should be interpreted in the light of possible limitations. Some suggestions for clinical practice are provided.

Ensayo no aleatorizado de una intervención educativa basada en principios cognitivo-conductuales para pacientes con lumbalgia crónica inespecífica atendidos en fisioterapia de atención primaria / Non-randomised trial of an educational intervention based on cognitive-behavioural principles for patients with chronic low back pain attended in Primary Care Physiotherapy

OBJETIVO: Valorar la influencia de una intervención educativa en la reducción del «miedo-evitación» (ME) y del «catastrofismo al dolor» (CAT) en población con lumbalgia crónica inespecífica (LCI) atendida en fisioterapia de atención primaria (AP). DISEÑO: Estudio cuasiexperimental. Emplazamiento: Centros de salud (CS) del Distrito Sanitario Costa del Sol. PARTICIPANTES: Pacientes con LCI entre 18-65 años con comprensión del idioma español; ausencia de intervenciones educativas paralelas; ausencia de banderas rojas; ausencia de deterioro cognitivo y/o fibromialgia; ausencia de cirugía dorsolumbar, y tolerancia al ejercicio físico. INTERVENCIONES: El grupo control recibió la EdE grupal habitual. El experimental recibió, además, un instrumento escrito para lectura domiciliaria, más la posterior puesta en común, aclaración de dudas y reestructuración de creencias y metas durante el desarrollo de las sesiones. Ambas intervenciones duraron unos 280 min (7 sesiones de 40 min). RESULTADOS: Las variables principales incluyeron ME y CAT. Secundariamente se valoraron dolor y discapacidad. Algunas variables «sociodemográficas» y «relacionadas con el trastorno» fueron tenidas en cuenta en el análisis. Se observaron diferencias estadísticamente significativas en el grupo experimental versus control en la variación del ME −14 (−25,5; 0) vs −4 (−13; 0) (p = 0,009), y del CAT −9 (−18; −4) vs −4,5 (−8,25; 0) (p = 0,000). Igualmente se observaron diferencias en discapacidad (p = 0,046), pero no en dolor (p = 0,280). CONCLUSIONES: Los resultados deben ser considerados a la luz de las posibles limitaciones que plantea el estudio. Su naturaleza pragmática permitiría una potencial transferencia a la dinámica asistencial habitual

OBJECTIVE: To assess the influence of an educational intervention in reducing «fear-avoidance» (FA) and «pain catastrophising» (CAT) in a population with unspecific chronic low back pain (UCLBP), attending physiotherapy in Primary Health Care. A pragmatic quasi-experimental study was conducted in Health Centres of a Costa del Sol Health District. DESIGN: Quasi-experimental study. SETTING: Primary Health Care physiotherapy Back Schools in Health Centres of a Costa del Sol Health District. PARTICIPANTS: The selection criteria were: UCLBP; 18-65 years; understanding of the Spanish language; absence of parallel educational interventions; absence of red flags; not showing cognitive impairment or fibromyalgia; absence of thoracic-lumbar surgery, and exercise tolerance. INTERVENTIONS: The control group received the usual Back Schools program. The experimental group also received a written document for home reading, plus the subsequent sharing, clarifying doubts, and beliefs and goals restructuring during the development of the sessions. Both interventions lasted about 280 minutes (7 sessions × 40min). RESULTS: The main variables included FA and CAT. Pain and disability were also assessed. Some «demographic» and «related disorder» variables were considered in the analysis. Statistically significant differences were observed in the experimental group versus control, in the variation of FA −14 (−25.5; 0) vs −4 (−13; 0) (P=.009), and CAT −9 (−18; −4) vs −4,5 (−8.25; 0) (P=.000), were observed. Also differences in disability (P=.046), but not in pain (P=.280). CONCLUSIONS: These results should be considered in light of possible limits imposed by the study. Its pragmatic nature would allow a potential transfer to usual care

Efecto del bloqueo del factor de necrosis tumoral α sobre el metabolismo óseo en las enfermedades inflamatorias articulares crónicas / Effect of tumour necrosis factor α blockade on bone metabolism in chronic inflammatory joint diseases

Fundamento y objetivo: Evaluar el efecto de los tratamientos anti-TNF sobre la densidad mineral ósea (DMO), los marcadores de remodelado óseo (MRO) y la ratio receptor activator for nuclear factor κB ligand (RANKL, «ligando del receptor activador del factor nuclear κB»)/osteoprotegerina (OPG) en los pacientes con enfermedades inflamatorias articulares crónicas. Métodos: Estudio longitudinal prospectivo en condiciones de práctica clínica sobre 31 pacientes diagnosticados de artritis reumatoide, artropatía psoriásica y espondilitis anquilosante que estuvieron durante un año en tratamiento con fármacos anti-TNF alfa. Al inicio y al final del estudio se evaluaron la DMO, la OPG y la forma soluble de RANKL (sRANKL), y durante el estudio (0, 3, 6, 9 y 12 meses), la actividad de la enfermedad (SDAI, BASDAI y PCR), la capacidad funcional (HAQ, BASFI), los MRO y la vitamina D. Resultados: La DMO no se modificó después de un año de tratamiento. Los pacientes que consumieron corticoides tuvieron una pérdida media de masa ósea del 3% en el raquis lumbar (± 1,6, p = 0,02). En cuanto a los MRO, no experimentaron cambios significativos a lo largo del estudio. Disminuyó la actividad de la enfermedad, tanto SDAI (p = 0,002) como BASDAI (p = 0,002). La OPG se mantuvo sin cambios durante el año de tratamiento, mientras que disminuyeron significativamente tanto el sRANKL (0,28 ± 0,22, p = 0,013) como la ratio sRANKL/OPG (0,04 ± 0,03, p = 0,031). Conclusión: Los pacientes en tratamiento con anti-TNF no presentaron una pérdida de DMO significativa durante el seguimiento (un año), a la vez que experimentaron una mejora de la actividad de la enfermedad. Estos resultados han sido más evidentes en los pacientes respondedores (AU)

Background and objective: To evaluate the effect of anti-TNF treatments on bone mineral density (BMD), bone remodelling markers (BRM) and receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) in patients with chronic inflammatory joint diseases. Methods: A longitudinal prospective study was performed under clinical practice conditions on 31 patients diagnosed of rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis who had received treatment with anti-TNF alpha drugs for one year. BMD, OPG and RANKL soluble form (sRANKL) were studied at the onset and end of the study. During the study (0, 3, 6, 9 and 12 month), disease activity (SDAI, BASDAI and CRP), functional capacity (HAQ, BASFI), BRM and vitamin D were studied. Results: BMD was not modified after one year of treatment. The patients who took corticosteroids had a mean bone mass loss of 3% in the lumbar spine (± 1.6, P = .02). In regards to the BRM, did not experience significant changes over the course of the study. Disease activity, both SDAI (P = .002) and BASDAI (P = .002), decreased. OPG was maintained without changes during the year of treatment while both the sRANKL (0.28 ± 0.22, P = .013) and sRANKL/OPG ratio significantly decreased (0.04 ± 0.03,P = .031). Conclusion: The patients being treated with anti-TNF did not present with a significant loss of DMO during the study (one year), at the same time experiencing an improvement in disease activity. This protection has been clearer in the responding patients (AU)

[Effect of tumour necrosis factor α blockade on bone metabolism in chronic inflammatory joint diseases]. / Efecto del bloqueo del factor de necrosis tumoral α sobre el metabolismo óseo en las enfermedades inflamatorias articulares crónicas.

BACKGROUND AND OBJECTIVE: To evaluate the effect of anti-TNF treatments on bone mineral density (BMD), bone remodelling markers (BRM) and receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) in patients with chronic inflammatory joint diseases. METHODS: A longitudinal prospective study was performed under clinical practice conditions on 31 patients diagnosed of rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis who had received treatment with anti-TNF alpha drugs for one year. BMD, OPG and RANKL soluble form (sRANKL) were studied at the onset and end of the study. During the study (0, 3, 6, 9 and 12 month), disease activity (SDAI, BASDAI and CRP), functional capacity (HAQ, BASFI), BRM and vitamin D were studied. RESULTS: BMD was not modified after one year of treatment. The patients who took corticosteroids had a mean bone mass loss of 3% in the lumbar spine (±1.6, P=.02). In regards to the BRM, did not experience significant changes over the course of the study. Disease activity, both SDAI (P=.002) and BASDAI (P=.002), decreased. OPG was maintained without changes during the year of treatment while both the sRANKL (0.28±0.22, P=.013) and sRANKL/OPG ratio significantly decreased (0.04±0.03, P=.031). CONCLUSION: The patients being treated with anti-TNF did not present with a significant loss of DMO during the study (one year), at the same time experiencing an improvement in disease activity. This protection has been clearer in the responding patients.

[Non-randomised trial of an educational intervention based on cognitive-behavioural principles for patients with chronic low back pain attended in Primary Care Physiotherapy]. / Ensayo no aleatorizado de una intervención educativa basada en principios cognitivo-conductuales para pacientes con lumbalgia crónica inespecífica atendidos en fisioterapia de atención primaria.

OBJECTIVE: To assess the influence of an educational intervention in reducing «fear-avoidance¼ (FA) and «pain catastrophising¼ (CAT) in a population with unspecific chronic low back pain (UCLBP), attending physiotherapy in Primary Health Care. A pragmatic quasi-experimental study was conducted in Health Centres of a Costa del Sol Health District. DESIGN: Quasi-experimental study. SETTING: Primary Health Care physiotherapy Back Schools in Health Centres of a Costa del Sol Health District. PARTICIPANTS: The selection criteria were: UCLBP; 18-65years; understanding of the Spanish language; absence of parallel educational interventions; absence of red flags; not showing cognitive impairment or fibromyalgia; absence of thoracic-lumbar surgery, and exercise tolerance. INTERVENTIONS: The control group received the usual Back Schools program. The experimental group also received a written document for home reading, plus the subsequent sharing, clarifying doubts, and beliefs and goals restructuring during the development of the sessions. Both interventions lasted about 280minutes (7 sessions×40min). RESULTS: The main variables included FA and CAT. Pain and disability were also assessed. Some «demographic¼ and «related disorder¼ variables were considered in the analysis. Statistically significant differences were observed in the experimental group versus control, in the variation of FA -14 (-25.5; 0) vs -4 (-13; 0) (P=.009), and CAT -9 (-18; -4) vs -4,5 (-8.25; 0) (P=.000), were observed. Also differences in disability (P=.046), but not in pain (P=.280). CONCLUSIONS: These results should be considered in light of possible limits imposed by the study. Its pragmatic nature would allow a potential transfer to usual care.

La extensión de la enfermedad coronaria determina la movilización de las células progenitoras endoteliales y las citocinas tras un primer infarto de miocardio con elevación del ST / Coronary disease extension determines mobilization of endothelial progenitor cells and cytokines after a first myocardial infarction with ST elevation

Introducción y objetivos. La enfermedad coronaria multivaso es un importante factor pronóstico postinfarto a pesar de nuevas formas de reperfusión como la angioplastia primaria. El objetivo del presente estudio es determinar la secuencia de variación de diferentes poblaciones de células progenitoras endoteliales y factores angiogénicos (factor de crecimiento endotelial vascular, factor de crecimiento hepatocitario) según el grado de extensión de la enfermedad coronaria. Métodos. Estudiamos la cinética de liberación en 32 pacientes ingresados por un primer infarto, agrupados según tuvieran enfermedad coronaria monovaso o multivaso y 26 sujetos que constituyen el grupo control. Resultados. Los pacientes presentaban un mayor número de células progenitoras endoteliales y citocinas angiogénicas que los controles en las tres determinaciones realizadas (al ingreso, día 3 y día 7) de las siguientes subpoblaciones: CD34, CD34+CD133+, CD34+KDR+ y CD34+CD133+KDR+CD45+ (débil); este último era mayor el día 7. Los valores de las tres poblaciones analizadas eran mayores en los pacientes con enfermedad coronaria monovaso en las tres determinaciones. Las cifras del factor de crecimiento endotelial vascular subían durante la primera semana y las del factor de crecimiento hepatocitario mostraron un pico precoz al ingreso. No apreciamos diferencias significativas en las variaciones de citocinas según el grado de extensión de la enfermedad coronaria. Conclusiones. Aunque las cinéticas de liberación de diferentes poblaciones de células progenitoras endoteliales en pacientes con un primer infarto agudo de miocardio con enfermedad monovaso con enfermedad multivaso fueron similares, su número fue mayor en los pacientes con enfermedad coronaria monovaso. Las cifras del factor de crecimiento endotelial vascular ascendieron durante la primera semana y las del factor de crecimiento hepatocitario muestran un pico precoz al ingreso (AU)

Introduction and objectives. Multivessel coronary disease is still a postinfarction prognostic marker despite new forms of reperfusion, such as primary angioplasty. The aim of this study was to determine the time sequence of various sets of endothelial progenitor cells and angiogenic cytokines (vascular endothelial growth factor, hepatocyte growth factor) according to the degree of extension of the postinfarction coronary disease. Methods. We studied the release kinetics in 32 patients admitted for a first myocardial infarction with ST elevation, grouped according to whether they had single or multivessel disease, and 26 controls. Results. The patients had a higher number of endothelial progenitor cells and angiogenic cytokines than the controls at all 3 measurements (admission, day 3, and day 7) of the following subsets: CD34, CD34+CD133+, CD34+KDR+, and CD34+CD133+KDR+CD45+(weak); this latter was higher on day 7. The levels of these cell subsets were all higher in the patients with single-vessel disease and at all 3 measurements. The vascular endothelial growth factor levels were raised during the first week and the hepatocyte growth factor showed an early peak on admission for infarction. No significant differences were seen in the cytokines according to coronary disease extension. Conclusions. Although the release kinetics of different subsets of endothelial progenitor cells in patients with a first acute myocardial infarction with ST elevation was similar in those with single vessel disease to those with multivessel disease, the number of circulating endothelial progenitor cells was greater in the patients with single vessel disease. The vascular endothelial growth factor levels were raised during the first postinfarction week and the hepatocyte growth factor were higher on admission (AU)

[Coronary disease extension determines mobilization of endothelial progenitor cells and cytokines after a first myocardial infarction with ST elevation]. / La extensión de la enfermedad coronaria determina la movilización de las células progenitoras endoteliales y las citocinas tras un primer infarto de miocardio con elevación del ST.

INTRODUCTION AND OBJECTIVES: Multivessel coronary disease is still a postinfarction prognostic marker despite new forms of reperfusion, such as primary angioplasty. The aim of this study was to determine the time sequence of various sets of endothelial progenitor cells and angiogenic cytokines (vascular endothelial growth factor, hepatocyte growth factor) according to the degree of extension of the postinfarction coronary disease. METHODS: We studied the release kinetics in 32 patients admitted for a first myocardial infarction with ST elevation, grouped according to whether they had single or multivessel disease, and 26 controls. RESULTS: The patients had a higher number of endothelial progenitor cells and angiogenic cytokines than the controls at all 3 measurements (admission, day 3, and day 7) of the following subsets: CD34, CD34+CD133+, CD34+KDR+, and CD34+CD133+KDR+CD45+(weak); this latter was higher on day 7. The levels of these cell subsets were all higher in the patients with single-vessel disease and at all 3 measurements. The vascular endothelial growth factor levels were raised during the first week and the hepatocyte growth factor showed an early peak on admission for infarction. No significant differences were seen in the cytokines according to coronary disease extension. CONCLUSIONS: Although the release kinetics of different subsets of endothelial progenitor cells in patients with a first acute myocardial infarction with ST elevation was similar in those with single vessel disease to those with multivessel disease, the number of circulating endothelial progenitor cells was greater in the patients with single vessel disease. The vascular endothelial growth factor levels were raised during the first postinfarction week and the hepatocyte growth factor were higher on admission.

Deformación ventricular izquierda en ecocardiografía bidimensional: valores y tiempos en sujetos normales / Left ventricular deformation and two-dimensional echocardiography: temporal and other parameter values in normal subjects

El análisis de la deformación o strain y la tasa de deformación o strain rate podrían valorar cuantitativamente la contractilidad segmentaria. Esto es factible con Doppler tisular y, más recientemente, también con ecografía bidimensional mediante el rastreo de señales miocárdicas (speckle tracking). Este trabajo se diseñó para conocer el valor de estos parámetros en sujetos sanos y su reproducibilidad. Se estudió a 105 sujetos sanos —55 mujeres (52,45%); edad, 38,8 ± 9,5 (20-59) años— mediante speckle tracking con la aplicación Vector Velocity Imaging. Se obtuvieron los valores medios de strain y strain rate de cada segmento, así como el tiempo hasta el pico máximo, normalizado con la longitud del ciclo (TpN). Los valores medios fueron: strain circunferencial, 22,2 ± 4,81% con TpN 0,39 ± 0,06; strain longitudinal, 19,84 ± 4,59% con TpN 0,42 ± 0,06; strain rate circunferencial, 1,64 ± 0,48 1/s con TpN 0,23 ± 0,06; strain rate longitudinal, 1,3 ± 0,49 1/s con TpN 0,21 ± 0,09. Las variabilidades del observador y entre observadores fueron moderadas (AU)

Segmental contractility can be assessed quantitatively by analyzing deformation, or strain, and the rate of deformation, or the strain rate. This type of analysis can be performed using either tissue Doppler imaging or, more recently, two-dimensional speckle-tracking echocardiography. The aim of this study was to determine typical parameter values in healthy subjects and their reproducibility. The study involved 105 healthy individuals, including 55 women (52.45%). Their mean age was 38.8±9.5 years (range, 20-59 years). All underwent speckle-tracking echocardiography with velocity vector imaging. Mean values for the strain and strain rate for each segment as well as for the time-to-peak normalized by the length of the cycle (TPN) were obtained. The resulting mean values were: circumferential strain, 22.2±4.81% with a TPN of 0.39±0.06; longitudinal strain, 19.84±4.59% with a TPN of 0.42±0.06; circumferential strain rate, 1.64±0.48 1/s with a TPN of 0.23±0.06; and longitudinal strain rate, 1.3±0.49 1/s with a TPN of 0.21±0.09. Intra- and interobserver variability were moderate in magnitude (AU)

Left ventricular deformation and two-dimensional echocardiography: temporal and other parameter values in normal subjects.

Segmental contractility can be assessed quantitatively by analyzing deformation, or strain, and the rate of deformation, or the strain rate. This type of analysis can be performed using either tissue Doppler imaging or, more recently, two-dimensional speckle-tracking echocardiography. The aim of this study was to determine typical parameter values in healthy subjects and their reproducibility. The study involved 105 healthy individuals, including 55 women (52.45%). Their mean age was 38.8 ± 9.5 years (range, 20-59 years). All underwent speckle-tracking echocardiography with velocity vector imaging. Mean values for the strain and strain rate for each segment as well as for the time-to-peak normalized by the length of the cycle (TPN) were obtained. The resulting mean values were: circumferential strain, 22.2 ± 4.81% with a TPN of 0.39 ± 0.06; longitudinal strain, 19.84 ± 4.59% with a TPN of 0.42 ± 0.06; circumferential strain rate, 1.64 ± 0.48 1/s with a TPN of 0.23 ± 0.06; and longitudinal strain rate, 1.3 ± 0.49 1/s with a TPN of 0.21 ± 0.09. Intra- and inter-observer variability were moderate in magnitude.