{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T16:43:51Z","timestamp":1786293831068,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>By combining left ventricular (LV) global longitudinal strain (GLS) with LV volume during the cardiac cycle, LV strain\u2010volume loops (SV\u2010loops) can be generated. LV SV\u2010loop derived parameters provide new insights into the interaction between cardiac contraction and volume in a variety of cardiac diseases and may even have prognostic value. The aim of this study is to describe SV\u2010loops in a healthy adult population and investigate potential sex\u2010 and age\u2010related differences of LV SV\u2010loop characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 125 healthy volunteers aged 18\u201372 years, apical 2\u2010, 3\u2010 and 4\u2010chamber views were acquired to measure GLS. Custom software was used to combine strain and volume data to construct SV\u2010loops. Different parameters were derived: (i) linear slope of systolic strain\u2010volume relation (S\u2010Slope); (ii) linear slope of early\u2010systolic strain\u2010volume relation (ES\u2010Slope); (iii) linear slope of early\u2010diastolic strain\u2010volume relation (ED\u2010Slope); (iv) linear slope of late\u2010diastolic strain\u2010volume relation (LD\u2010slope) and (v) uncoupling between systolic and diastolic strain\u2010volume relation (UNCOUP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For systolic strain\u2010volume relation, higher values were observed in females compared to males, with S\u2010Slope values of 0.19 %\/mL m\n                      <jats:sup>\u22122<\/jats:sup>\n                      [0.17\u20130.22] and 0.13 %\/mL m\n                      <jats:sup>\u22122<\/jats:sup>\n                      [0.11\u20130.14], respectively (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Similarly, ED\u2010Slope was higher in females than in males, with values of 0.18 %\/mL m\n                      <jats:sup>\u22122<\/jats:sup>\n                      [0.10\u20130.28] and 0.12 %\/mL m\n                      <jats:sup>\u22122<\/jats:sup>\n                      [0.06\u20130.18] respectively (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003). Low values for uncoupling between the systolic and diastolic strain\u2010volume relation were observed, with a mean value of 0.34 \u00b1 1.1. Additionally, UNCOUP was positively correlated with age (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.4;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher values observed in systolic and early\u2010diastolic strain\u2010volume relation in females may reflect sex\u2010specific differences in LV contraction. While the exact mechanisms remain unclear, these findings suggest potential variations in myocardial deformation patterns that warrant further investigation. Consistent with previous work, relative coupling of the systolic and diastolic strain\u2010volume relationship was identified in our cohort of healthy individuals. However, with increasing age, higher values for uncoupling were observed, suggesting age\u2010related alterations in ventricular mechanics that may contribute to changes in cardiac function over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70534","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:42:44Z","timestamp":1780922564000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Ventricular Strain\u2010Volume Loops in a Healthy Population: The Role of Sex and Age"],"prefix":"10.1111","volume":"43","author":[{"given":"Robert R.","family":"Zwaan","sequence":"first","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zo\u00eb A.","family":"Keuning","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijs P.","family":"Kerstens","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Deventer ziekenhuis  Deventer the Netherlands"},{"name":"Department of Medical Biosciences Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Bowen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"},{"name":"Department of Radiology and Nuclear Medicine Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik J.","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie P. J.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick H. J.","family":"Thijssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolien W.","family":"Roos\u2010Hesselink","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD\u2010Heart)  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemien E. van den","family":"Bosch","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiovascular Institute Thorax Center Erasmus MC  Rotterdam the Netherlands"},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD\u2010Heart)  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.109.862334"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305538"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa123"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP273526"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00190.2019"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.01.084"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","unstructured":"Z. A.Keuning T. P.Kerstens R. R.Zwaan et\u00a0al. \u201cLeft Ventricular Strain\u2010Volume Loops in Bicuspid Aortic Valve Disease: New Insights in Cardiomechanics \u201dEuropean Heart Journal. Imaging Methods and Practice2 no.2(2024):qyae020.","DOI":"10.1093\/ehjimp\/qyae020"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-016-0910-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.13323"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","unstructured":"J.Nyberg E. O.Jakobsen A.\u00d8stvik et\u00a0al. \u201cEchocardiographic Reference Ranges of Global Longitudinal Strain for All Cardiac Chambers Using Guideline\u2010Directed Dedicated Views \u201dJACC. 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