Influence of chest conformation on myocardial strain parameters in healthy subjects with mitral valve prolapse

Raw data. Abstract<br> Chest shape might affect myocardial strain parameters. However, the relationship between myocardial strain parameters and<br> chest conformation has not been previously investigated in subjects with mitral valve prolapse (MVP). Between April 2019<br> and May 2020, 60 healthy subjects (50.1 ± 8.6 year/old, 46.6% females) with MVP and mild-to-moderate mitral regurgitation,<br> and 60 controls matched by age, sex, and cardiovascular risk factors were consecutively studied. Participants underwent<br> modified Haller index (MHI) assessment (ratio of chest transverse diameter over the distance between sternum and spine),<br> and transthoracic echocardiography implemented with 2D-speckle tracking analysis. MHI was significantly greater in MVP<br> group than controls (2.6 ± 0.35 vs 2.1 ± 0.23, p &lt; 0.0001). Left ventricular (LV) ejection fraction was similar in MVP and<br> controls (63.5 ± 3.7% vs 64.3 ± 3.9%, p = 0.25). LV regional and global longitudinal (GLS), circumferential (GCS) and radial<br> strain (GRS) parameters and LV peak twist were all significantly lower in MVP compared to controls (all p &lt; 0.0001). MVP<br> subjects with a tight chest (MHI &gt; 2.5, n = 30), and those with MHI ≤ 2.5 (n = 30) were then separately analyzed. A significant<br> impairment in myocardial strain parameters and LV peak twist was documented in MVP subjects with MHI &gt; 2.5, but not in<br> those with MHI ≤ 2.5. MHI showed a strong inverse correlation with LV-GLS (r = − 0.85), GCS (r = − 0.84), GRS (r = − 0.84)<br> and LV peak twist (r = − 0.94). In MVP subjects, impairment of myocardial strain parameters is not due to intrinsic reduction<br> of cardiac contractility function, but it appears to be related to the degree of chest deformity.