Abstract 11752: Correlation of Myocardial Work Parameters With Left Ventricular Ejection Fraction in Patients With Chagas Disease From a Quaternary Hospital in Brazil

Abstract

Introduction: Although left ventricular ejection fraction (LVEF) is one important parameter for management of pts with heart diseases and a major prognostic factor in Chagas cardiomyopathy (CC), it has great variability. Myocardial Work (MW) is a new promising technique which integrates afterload to longitudinal strain analysis using noninvasive blood pressure (NIBP) values, calculating pressure x strain loops (PSL). Correlation of MW with LVEF in pts with CC is unknown. Hypothesis: LV MW may have good correlation with LVEF in pts with Chagas Disease (CD). Methods: We included 39 consecutive pts(74,4% women, median age 68,8±9,7) followed in a quaternary Brazilian hospital with diagnosis of CD, dividing them into groups based on the stages of heart disease: Group 1: normal Echocardiography (Echo) and ECG, Group 2: pts with alterations in ECG and/or Echo with preserved LVEF, Group 3: pts with reduced LVEF with or without heart failure. A comprehensive Echo was performed in all pts, and LVEF was measured by 2D biplane Simpson. LV MW was measured using speckle-tracking echo, using NIBP as an afterload index for generation of PSL by a specific software. Global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were measured. Results: 11 pts (28,2%) were classified in group 1, 14 (35,9%) in group 2, and 14 (35,9%) in group 3. There was a very strong correlation of LVEF with GWI (p<0,001; r=0,781), GCW (p<0,001; r=0,813), a strong correlation pf LVEF with GWE (p<0,001; r=0,661) and a weak correlation of LVEF with GWW (p=0,046; r=-0,332). All MW parameters, except from GWW had good sensitivity and specificity to detect pts with reduced LVEF, with best cutoff for GWI = 1501mmHg% (AUC=0,980) and GCW=1719,5mmHg% (AUC=0,986). Conclusions: MW parameters, except from GWW, had strong correlation with LVEF in this subset of pts with CD, with good performance for the detection of LVEF≤52%, with high sensitivity and specificity.