Global longitudinal strain and echocardiographic parameters of left ventricular geometry and systolic function in healthy adult Angolans: Effect of age and gender

Introduction: Studies on the normal echocardiographic reference values in Africans are limited. Objectives: This study aims to establish the normal left ventricular echocardiographic parameters for adult Angolans, stratified by gender and age. Methods: A cross-sectional study was performed involving healthy adults attending a diagnostic center in Luanda, Angola. The two-dimensional transthoracic echocardiography was performed according to the Guidelines of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Results: A total of 103 men (47.5%) (mean age: 39.5±10,8) and 114 women (52.5%) (mean age: 43.0±12,5 years) were included. Compared to men, women were older (p=0.025) and had a significantly smaller body surface area (BSA) (p<0.001). Left ventricular wall thickness, left ventricular end-diastolic dimension and volume (LVEDV), left ventricular mass (LVM) and LVM indexed to BSA (LVMi) were significantly lower in women (p<0.005). LVEDD indexed to BSA and left ventricular ejection fraction (LVEF) were significantly higher in women than in men (p=0.007), (p=0.01), respectively. Mitral annular plane systolic excursion, LVEF by strain, and global longitudinal strain showed no gender differences. Posterior wall thickness showed a statistically significant increase in the older groups (p=0.043). The VST, relative wall thickness, LVM, and LVMi showed no significant differences between age categories. In turn, the shortening fraction and the ejection fraction increase with age. Conclusion: For a more sensitive morphological and functional assessment of the left ventricle, it is necessary to take into account the gender and age of the individual.