Key result
Ischemic cardiomyopathy, compared to nonischemic, showed worse peak systolic longitudinal strain in apical segments (p=0.008) but comparable global longitudinal strain (p=0.26).
Why the study?
To compare left ventricular strain parameters using two-dimensional strain imaging in patients with heart failure with LVEF ≤35% based on ischemic versus non-ischemic etiology.
Cross-Sectional (n=133)
Patients with ischemic and non-ischemic heart failure demonstrate distinct regional patterns of left ventricular longitudinal strain impairment despite having comparable global ejection fractions.
Regional LV strain patterns differ by ICM vs NICM etiology despite similar globals; hypothesis-generating for etiology-specific assessment pending prospective validation.
Aim. To carry out a comparative analysis of left ventricular (LV) strain parameters, determined by the two-dimensional strain imaging in patients with heart failure (HF) with LV ejection fraction (EF) ≤35%, depending on the origin of HF. Material and methods. The study included 133 patients with NYHA class 3-4 HF with LVEF ≤35%, taking optimal therapy. Based on the HF origin, 2 following groups of patients were formed: ischemic cardiomyopathy (ICM) (n=70), nonischemic cardiomyopathy (NICM) (n=63). All patients underwent speckle-tracking echocardiography. Results. All patients included in the study showed significant alterations in longitudinal strain parameters in most myocardial segments, most pronounced in the basal and middle parts of the LV. Comparative analysis of the peak systolic longitudinal strain showed the worst characteristics in patients with ICM were found in the apical segments (p=0,008), and in patients with NICM, in the basal segments of the LV (p=0,046). The studied groups had comparable LV global longitudinal and circumferential strain (p=0,26; p=0,67; respectively). Conclusion. Groups of patients with HF of ischemic and non-ischemic origin, despite comparable LVEF values, differ in the distribution of the decrease in local longitudinal strain of LV segments. The worst strain characteristics in patients with ICM and NICM are detected in LV apical and basal segments, respectively.
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Илов et al. (2023) conducted a cross-sectional in Heart failure (n=133). Ischemic cardiomyopathy vs. Nonischemic cardiomyopathy was evaluated on Peak systolic longitudinal strain (p=0.008). Ischemic cardiomyopathy, compared to nonischemic, showed worse peak systolic longitudinal strain in apical segments (p=0.008) but comparable global longitudinal strain (p=0.26).
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