Association between left ventricular global longitudinal strain and natriuretic peptides in outpatients with chronic systolic heart failure.

F Gaborit,K Iversen,J P Goetze,T Kümler,M Schou,N Tønder,H Bosselmann,C Kistorp,G Sölétormos

doi:10.1186/s12872-015-0063-8

F Gaborit, K Iversen + Show 7 more

Open Access

https://doi.org/10.1186/s12872-015-0063-8

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Abstract

BackgroundBoth impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Increased levels of NP reflect increased wall stress of the LV. However, little is known about the relationship between LV GLS and NP. This aim of this study was to evaluate the relationship between the echocardiographic measure LV GLS and plasma levels of NP.MethodsWe prospectively included 149 patients with verified systolic HF at the baseline visit in an outpatient HF clinic. LV GLS was assessed by two dimension speckle tracking and plasma concentrations of N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) and pro-atrial-natriuretic-peptide (proANP) were analysed.ResultsThe patients had a median age of 70 years, 28.2 % were females, 26.5 % were in functional class III-IV, median left ventricular ejection fraction (LVEF) was 33 % and median LV GLS was −11 %. LV GLS was associated with increased plasma concentrations of NT-proBNP and proANP in multivariate logistic regression (NT-proBNP: Odds RatioGLS: 7.25, 95 %-CI: 2.48-21.1, P < 0.001 and proANP: Odds RatioGLS: 3.26, 95-%-CI: 1.28-8.30, P = 0.013) and linear regression (NT-proBNP: βGLS: 1.19, 95 %-CI: 0.62-1.76, P < 0.001 and proANP: βGLS: 0.42, 95-%-CI: 0.11-0.72, P = 0.007) models after adjustment for traditional confounders (age, gender, body-mass-index, atrial fibrillation, renal function) and left atrial volume index.ConclusionImpaired LV GLS is associated with increased plasma concentrations of NP and our data suggest that left ventricular myocardial mechanics estimated by LV GLS reflects myocardial wall stress in chronic systolic HF.

Highlights

Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF)
Among patients presenting with acute myocardial infarction, LV GLS is associated with development of heart failure (HF) and an increased mortality risk [6] as well as increased plasma concentrations of aminoterminal pro-brain natriuretic peptide(NT-proBNP) [7]
Diastolic function estimated by mitral valve deceleration time (P = 0.027) was reduced in patients with LV GLS above the median, but left atria size and E/e’ were not significantly affected by LV GLS

Summary

Introduction

Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Little is known about the relationship between LV GLS and NP This aim of this study was to evaluate the relationship between the echocardiographic measure LV GLS and plasma levels of NP. In chronic HF it has been shown that LV GLS has additional prognostic value and it can predict hospitalization for HF and an increased mortality risk [8,9,10]. It remains unknown whether LV GLS reflects e.g., myocardial

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