Myocardial volume change during cardiac cycle derived from three orthogonal systolic strains: towards a quality assessment of strains

The relative modification of the myocardial volume between end-systole and end-diastole ( V s / d = V end - systole / V end - diastole ) has already been assessed with different methods and falls in a range of 0.9–0.97 (mean value？=？0.93). To estimate V s / d from the three longitudinal ( ？ l ) , circumferential ( ？ c ), and radial ( ？ r ) strains of the left ventricle using the formula: V s / d = ( 1 + ？ c ) ( 1 + ？ r ) ( 1 + ？ l ) and to test whether this estimate of V s / d can be used as a marker of the echocardiography quality. Two hundred manuscripts, including a total of 34,690 patients or healthy volunteers, were identified in the Medline database containing values of ？ l , ？ c , and ？ r measured from echocardiography. The median value of was 0.93, in accordance with the literature, with no significant difference between patients or healthy volunteers (P = 0.38). The proportion of studies with V s / d = 0 . 93 ± 0 . 1 was 79%. When only considering groups of healthy volunteers, the studies failing this test had higher standard deviations for the three individual strains: 0.038 vs. 0.029 (P？=？0.02) for ？ l ; 0.060 vs. 0.034 (P？<？10–6) for ？ c , and 0.243 vs. 0.101 (P？<？10–14) for ？ r . The median ratio of the left ventricular myocardial volumes between end-systole and end-diastole in the investigated studies was V s / d = 0 . 93 . The formula ( 1 + ？ c ) ( 1 + ？ r ) ( 1 + ？ l ) ？ [ 0 . 83 ; 1 . 03 ] could be used to detect studies with inaccurate strain measurements