What does this research mean for the field?

In acute decompensated heart failure, there is a stronger interdependence between right ventricular and left atrial mechanics in HFpEF patients compared to HFrEF patients, independent of left ventricular ejection fraction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate differences in two-dimensional speckle tracking echocardiography parameters between acute decompensated heart failure phenotypes and assess their correlation with left ventricular ejection fraction.

July 9, 2026Frontiers in Cardiovascular MedicineOpen Access

Comparative analysis of myocardial strain parameters in acute decompensated heart failure phenotypes: a cross-sectional study

Q: What are the key findings of this study?

In patients with acute decompensated heart failure, those with HFrEF had significantly lower absolute values of left ventricular global longitudinal strain compared to those with HFpEF (median -10.4% vs -18.15%, p<0.001).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute decompensated heart failure (n=98). Intervention: Heart failure with reduced ejection fraction (HFrEF) vs. Heart failure with preserved ejection fraction (HFpEF). Primary outcome: Left ventricular global longitudinal strain (LV-GLS) (p=<0.001).

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Key result

Acute decompensated HFrEF shows substantially lower absolute LV-GLS compared to HFpEF.

P<0.001
n=98

Why the study?

Differences in 2D-STE parameters among patients with different types of ADHF and their correlation with LVEF needed investigation.

Does two-dimensional speckle tracking echocardiography (2D-STE) identify significant differences in myocardial strain parameters between HFrEF and HFpEF phenotypes in patients with acute decompensated heart failure?

Key Points

To evaluate differences in two-dimensional speckle tracking echocardiography parameters between acute decompensated heart failure phenotypes and assess their correlation with left ventricular ejection fraction.
Conducted a cross-sectional study in 98 hospitalized patients with acute decompensated heart failure categorized into heart failure with reduced ejection fraction (HFrEF, n=46) and preserved ejection fraction (HFpEF, n=52) using an LVEF threshold of ≤49%.
Performed transthoracic echocardiography and two-dimensional speckle tracking echocardiography within 72 hours of admission to measure left ventricular, left atrial, and right ventricular myocardial strain parameters.
Patients with HFpEF exhibited significantly higher absolute values of left ventricular strain (GLSA4C, GLSA2C, GLSA3C, and LV-GLS), right ventricular strain (RVFWSL and RV4CSL), and left atrial strain rates than patients with HFrEF (P < 0.05).
After adjusting for LVEF, LV-GLS remained significantly correlated with left atrial strain parameters (LASr-ED, LASrcd-ED, and LASrct-ED) across both heart failure groups (P < 0.05).
Correlations between right ventricular free wall strain and left atrial strain (LASr-ED and LASrct-ED) persisted after adjusting for LVEF in HFpEF (P < 0.05) but disappeared in HFrEF (P > 0.05).

Study Design

Type

Cross-Sectional (n=98)

Multicenter

Structured PICO

Population

98 patients hospitalized with acute decompensated heart failure, stratified by ejection fraction into HFrEF and HFpEF groups, evaluated using two-dimensional speckle tracking echocardiography.

Exposure

Two-dimensional speckle tracking echocardiography (2D-STE) to measure myocardial strain parameters (including LV-GLS, LASr, RVFWSL) within 72 hours of admission.

Comparator

Comparison between heart failure with reduced ejection fraction (HFrEF, LVEF ≤49%) and heart failure with preserved ejection fraction (HFpEF, LVEF ≥50%) phenotypes.

Outcome

Differences in 2D-STE parameters (GLSA4C, GLSA2C, GLSA3C, LV-GLS, LASR-ED, LASRD-ED, LASRT-ED, RVFWSL, RV4CSL) among ADHF subtypes and their correlation with left ventricular ejection fraction (LVEF).surrogate

Main Result

Absolute Event Rate: -10.4% vs -18.15%

p-value: p=<0.001

2D-STE reveals significant differences in myocardial strain between ADHF phenotypes, highlighting a stronger interdependence between right ventricular and left atrial mechanics in HFpEF compared to HFrEF.

Limitations

Small sample size
Absence of a separate HFmrEF analysis
Timing of echocardiography within the first 72 hours without strict standardization relative to clinical decongestion
Heart rate at the time of echocardiogram not included
Retrospective nature prevents establishing causal relationships
Potential inter-observer variability in echocardiographic data
Presence of various subtypes of HFpEF and HFrEF comorbidities may have contributed to negative results
Limited sample size of the HFmrEF group (n=8), requiring them to be combined with the HFrEF group for statistical power

Discussion

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Implication

LV-GLS differs by HF phenotype in acute decompensation; hypothesis-generating for strain-based phenotyping in prospective cohorts.

Cite This Study

Lin et al. (2026) conducted a cross-sectional in Acute decompensated heart failure (n=98). Heart failure with reduced ejection fraction (HFrEF) vs. Heart failure with preserved ejection fraction (HFpEF) was evaluated on Left ventricular global longitudinal strain (LV-GLS) (p=<0.001). In patients with acute decompensated heart failure, those with HFrEF had significantly lower absolute values of left ventricular global longitudinal strain compared to those with HFpEF (median -10.4% vs -18.15%, p<0.001).

synapsesocial.com/papers/6a58e84c8bb2b43182002127 https://doi.org/10.3389/fcvm.2026.1794242

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Comparative analysis of myocardial strain parameters in acute decompensated heart failure phenotypes: a cross-sectional study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Comparative analysis of myocardial strain parameters in acute decompensated heart failure phenotypes: a cross-sectional study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider