ABC | Volume 113, Nº5, November 2019

Original Article 3-Dimensional Echocardiography and 2-D Strain Analysis of Left Ventricular, Left Atrial and Right Ventricular Function in Healthy Brazilian Volunteers Roberto M. Saraiva , 1 E liza Maria B. Scolin, 1 Nicole P. Pacheco, 1 Maria Eduarda Bouret, 1 Mauro Felippe Felix Mediano, 1, 2 M arcelo T. Holanda, 1 Andréa R. da Costa 1 Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, 1 Rio de Janeiro, RJ – Brazil Departamento de pesquisa e Educação, Instituto Nacional de Cardiologia, 2 Rio de Janeiro, RJ – Brazil Mailing Address: Roberto M. Saraiva • Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz Av. Brasil, 4365. Postal Code 21040-900, Rio de Janeiro, RJ – Brazil E-mail: roberto.saraiva@ini.fiocruz.br Manuscript received August 19, 2018, revised manuscript December 10, 2018, accepted February 13, 2019. DOI: 10.5935/abc.20190155 Abstract Background: New echocardiographic techniques are used in the diagnosis and prognosis of many heart diseases. However, reference values in different populations are still needed for several of these new indexes. We studied these new echocardiographic parameters in a group of Brazilians with no known cardiovascular disease. Objective: To study values for new echocardiographic indexes in Brazilians without known cardiovascular disease and their correlation with age. Methods: Cross-sectional study that included healthy individuals who underwent three-dimensional echocardiography (3DE) and two-dimensional speckle tracking echocardiography (STE) strain ( ε ) analysis. Left atrial (LA) and left ventricular (LV) function were analyzed by 3DE and STE, and right ventricular (RV) function by STE. P values < 0.05 were considered significant. Results: Seventy-seven subjects (46.7% men; 40.4  ±  10.4 years) were included. Maximum, minimum and pre-atrial contraction (pre-A) LA volumes (ml/m 2 ) were 21.2 ± 5.5, 7.8 ± 2.5, and 11.0 ± 3.1, respectively. Peak positive global LA ε (LAScd), peak negative global LA ε and total global LA ε (LASr) were 17.4 ± 5.2%, -13.2 ± 2.0% and 30.5 ± 5.9%, respectively. LV end-diastolic and end-systolic volumes (ml/m 2 ) measured 57 ± 12 and 24 ± 6, and 3D LV ejection fraction measured 58 ± 6%. Global LV longitudinal, circumferential and radial ε were -19 ± 2%, -19 ± 3%, and 46 ± 12%, respectively. LV torsion measured 1.6 ± 0.7 0 /cm. Global longitudinal RV ε (RV-GLS) and RV free wall strain were -22 ± 3% and -24 ± 5%. Minimum LA and pre-A volumes, LV apical rotation, torsion and RV-GLS increased with age, while total and passive LA emptying fractions, LAScd, LASr, LV end-diastolic and end-systolic volumes decreased with age. Conclusion: Values for new echocardiographic indexes in Brazilians without known cardiovascular disease and their correlation with age are presented. (Arq Bras Cardiol. 2019; 113(5):935-945) Keywords: Cardiovascular Diseases; Echocardiography, Three-Dimensional; Reference Values; Left Ventricular Function; Right Ventricular Function; Strain; Speckle Tracking. Introduction New echocardiographic techniques are being increasingly used in the diagnosis and prognosis of many cardiac diseases. 1-3 However, reference values in different populations are still needed for several of the new indexes derived from those techniques. Left ventricular (LV), left atrial (LA) and right ventricular (RV) function can be evaluated by both three‑dimensional echocardiography (3DE) and two‑dimensional speckle tracking echocardiography (STE) strain ( ε ) analysis. Reference values for some of the indexes derived from those techniques can be found in recent guidelines but are still missing in many of them. 1 Consequently, studies regarding the evaluation of LV, LA, and RV function in different conditions require control groups, which may not represent a real consistent sample of a normal population. Furthermore, the Brazilian population is often underrepresented in studies that assessed reference values for those parameters. Therefore, we studied new echocardiographic parameters and their correlation with age in Brazilians without known cardiovascular disease. Methods Study subjects This is a cross-sectional prospective study that recruited subjects among those referred to our institution, who tested negative for Chagas disease in two different serological tests, had no known diseases, presented normal physical examination, normal electrocardiogram and echocardiograms with normal global and segmental LV systolic function and no significant valvular heart disease. Race/ethnicity was obtained 935