Key result
Speckle tracking echocardiography in patients with CHF and preserved ejection fraction revealed reduced global longitudinal strain (-16.56±2.61%) and alterations in diastolic function.
Why the study?
The study was conducted to evaluate myocardial function in patients with chronic heart failure and preserved left ventricular ejection fraction using speckle tracking echocardiography and tissue Doppler imaging.
Can tissue Doppler imaging and speckle tracking echocardiography detect myocardial dysfunction in patients with chronic heart failure with preserved ejection fraction?
Cross-Sectional (n=115)
Can tissue Doppler imaging and speckle tracking echocardiography detect myocardial dysfunction in patients with chronic heart failure with preserved ejection fraction?
Speckle tracking echocardiography and tissue Doppler imaging reveal subclinical systolic dysfunction, such as reduced global and segmental longitudinal strain, in patients with HFpEF despite preserved LVEF.
Speckle tracking may detect subclinical dysfunction in HFpEF; leaves open its prognostic or therapeutic utility.
AIM: to study myocardial function in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction (PEF) by speckle tracking echocardiography and tissue doppler imaging. MATERIALS AND METHODS: We examined 80 patients aged 50-70 years with verified NYHA class I-IIa CHF and PEF due to arterial hypertension and ischemic heart disease, and 35 healthy persons. Examination included echocardiography, and speckle-tracking echocardiography. RESULTS: According to 6-min walk test 26.9 % of patients had functional class (FC) I CHF, 48.3 % - FC II CHF, and 24.8 - FC III CHF. The mean left ventricular ejection fraction (Simpson's method) was 62.3±5.35 %, mean end systolic left atrial volume index - 45±8.1 ml / m2. All patients had left ventricular diastolic dysfunction: 60 patients - abnormal relaxation pattern, 20 patients - pseudonormal pattern. Other findings were reduced global longitudinal strain (GLS, -16.56±2.61 %) and GLS rate (GLSR, -0.75±0.11 s-1) of the left ventricle and reduced segmental strain and strain rate in basal anteroseptal (-13.62±3.44 % and -0.77±0.04 s-1, respectively) and basal anterolateral (-14.17±3.31 % and -0.81±0.11 s-1, respectively) segments. Lowering of global circular left ventricular strain and strain rate (-15.63±4.8% and -1.4±0.23 s-1, respectively) was found to be smaller than that of GLS (p<0.05). There was positive correlation between left ventricular systolic GLS and left atrial volume (r=0.601, р<0.01). CONCLUSIONS: In patients with CHF and PEF we revealed alterations of diastolic function (abnormal relaxation and pseudonormal patterns), reductions of global and segmental strain and strain rate of the left ventricle. More pronounced lowering of segmental strain and strain rate was registered in left ventricular basal anteroseptal and basal anterolateral segments. Circular strain was found to be slightly reduced, while radial strain was unchanged.
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Vdovenko et al. (2019) conducted a cross-sectional in Chronic heart failure with preserved left ventricular ejection fraction (n=115). Speckle tracking echocardiography and tissue doppler imaging vs. Healthy persons was evaluated on Myocardial function (global and segmental strain, strain rate, diastolic function). Speckle tracking echocardiography in patients with CHF and preserved ejection fraction revealed reduced global longitudinal strain (-16.56±2.61%) and alterations in diastolic function.
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