Strain-Volume Loop Dynamics: A Novel Perspective on Left Ventricular Dysfunction

BACKGROUND AND OBJECTIVES: Strain-volume loop (SVL) dynamics demonstrate the relationship between myocardial strain and left ventricular (LV) volume throughout the cardiac cycle, offering insights into both systolic and diastolic function. This study aimed to identify SVL characteristics that differentiate heart failure (HF) patients from those without cardiac disease. METHODS: This retrospective analysis included 352 individuals who underwent 3-dimensional (3D) echocardiography at tertiary care hospitals. Participants were classified into no cardiac disease, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF) groups. Temporal 3D strain and LV volume data from each frame were used to construct SVLs. Key parameters-systolic, early and late diastolic slopes, area between curves, and peak strain-were analyzed. RESULTS: Patients with HFpEF exhibited lower systolic slopes compared to those without cardiac disease, while patients with HFrEF had the lowest values (p