Left ventricular strain-volume loops and diastolic dysfunction in suspected heart failure with preserved ejection fraction.
Int J Cardiol
; 378: 144-150, 2023 05 01.
Article
en En
| MEDLINE
| ID: mdl-36796492
ABSTRACT
BACKGROUND:
Presence of left ventricular diastolic dysfunction (DD) is key in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). However, non-invasive assessment of diastolic function is complex, cumbersome, and largely based on consensus recommendations. Novel imaging techniques may help detecting DD. Therefore, we compared left ventricular strain-volume loop (SVL) characteristics and diastolic (dys-)function in suspected HFpEF patients. METHOD ANDRESULTS:
257 suspected HFpEF patients with sinus rhythm during echocardiography were prospectively included. 211 patients with quality-controlled images and strain and volume analysis were classified according to the 2016 ASE/EACVI recommendations. Patients with indeterminate diastolic function were excluded, resulting in two groups normal diastolic function (control; n = 65) and DD (n = 91). Patients with DD were older (74.8 ± 6.9 vs. 68.5 ± 9.4 years, p < 0.001), more often female (88% vs 72%, p = 0.021), and more often had a history of atrial fibrillation (42% vs. 23%, p = 0.024) and hypertension (91% vs. 71%, p = 0.001) compared to normal diastolic function. SVL analysis showed a larger uncoupling i.e., a different longitudinal strain contribution to volume change, in DD compared to controls (0.556 ± 1.10% vs. -0.051 ± 1.14%, respectively, P < 0.001). This observation suggests different deformational properties during the cardiac cycle. After adjustment for age, sex, history of atrial fibrillation and hypertension, we found an adjusted odds ratio of 1.68 (95% confidence interval 1.19-2.47) for DD per unit increase in uncoupling (range -2.95-3.20).CONCLUSION:
Uncoupling of the SVL is independently associated with DD. This might provide novel insights in cardiac mechanics and new opportunities to assess diastolic function non-invasively.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
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Disfunción Ventricular Izquierda
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Insuficiencia Cardíaca
/
Hipertensión
Límite:
Female
/
Humans
Idioma:
En
Revista:
Int J Cardiol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Países Bajos