Left ventricular reservoir strain in heart failure with preserved ejection fraction on cardiovascular pharmacotherapy

Backgroung Left atrial(LA) reservoir strain(RS) is measured by 2D speckle tracking echocardiography(STE). There are a number of studies that have shown both diagnostic and prognostic role of LA RS in heart failure with preserved ejection fraction(HFpEF). Purpose The aim of our study was to identify whether LV RS plays an important role for management of patients with HFpEF on cardiovascular pharmacotherapy. Methods We examined 85 patients with HFpEF(44 males and 41 females, 62±5 years) with concomitant cardiovascular diseases(chronic coronary syndromes, arterial hypertension, atrial fibrillation, valvular heart disease) and symptoms of HF. All patients received guideline directed medical therapy. Normal LA RS values were considered≥20%, pathologic values<20%. Electrocardiography, routine blood tests and transthoracic echocardiography(TTE) with LA RS(GE Vivid E95 equipment) was performed at clinic. Results All patients were previously diagnosed HFpEF, on cardiovascular pharmacotherapy and with typical symptoms of HF(dyspnea, fatigue, decreased exercise tolerance) during echocardiographic study. TTE parameters were the following: 2 patients LA size>40 mm(2.3%), LV wall motion abnormalities-18 patients(21%), all patients LVEF>50%. The results have shown that 70 out of 85 cases(88.2%) LA RS<20%, p<0.02. It is important to highlight that the study patients have been with different cardiovascular diseases. Consequently, we aimed to understand LA RS parameter’s clinical role independent of pathophysiological mechanisms of diseases. Conclusion Reduced LA RS may be considered a crucial parameter for reassessment of HFpEF pharmacological therapy in different clinical settings.LA RS