Abstract
Background: Contribution of global and regional longitudinal strain (GLS) for clinical assessment of patients with heart failure with preserved ejection fraction (HFpEF) is not well established. We sought to evaluate subclinical left ventricular dysfunction secondary to coronary artery disease (CAD) in HFpEF patients compared with hypertensive patients and age-matched healthy subjects. Material and methods: This was a retrospective study that included 148 patients (group 1 = 62 patients with HFpEF, group 2 = 46 hypertensive patients, and group 3 = 40 age-matched control subjects). Peak systolic segmental, regional (basal, mid, and apical), and global longitudinal strain were assessed for each study group using two-dimensional speckle-tracking echocardiography (2D-STE). Results: GLS values presented statistically significant differences between the three groups (p < 0.001); markedly increased values (more negative) were observed in the control group (−20.2 ± 1.4%) compared with HTN group values (−18.4 ± 3.0%, p = 0.031) and with HFpEF group values (−17.6 ± 2.3%, p < 0.001). The correlation between GLS values and HTN stages was significant, direct, and average (Spearman coefficient rho = 0.423, p < 0.001). GLS had the greatest ability to detect patients with HFpEF when HFpEF + CAD + HTN diastolic dysfunction (n = 30) + CON diastolic dysfunction (n = 2) from HFpEF + CAD + HTN + CON was analyzed. (optimal GLS limit of −19.35%, area under curve = 0.833, p < 0.001). Conclusions: Global longitudinal strain can be used for clinical assessment in differentiating coronary and hypertensive patients at higher risk for development of systolic dysfunction.
Highlights
Conventional echocardiographic markers of left ventricular (LV) function, despite their widespread use in current diagnostic and management guidelines of heart failure (HF) [1], have significant disadvantages, especially because recently HF with preserved ejection fraction (HFpEF, LVEF ≥ 50%) became the dominant presentation [2], requiring a reliable assessment of LV function
This retrospective study was conducted between 2019 and 2021 in the Cardiovascular Prevention and Rehabilitation Clinic of the Institute of Cardiovascular Diseases Timisoara, Romania, and included 3 groups of patients, as follows: group 1 (HFpEF) enrolled 62 coronary patients with heart failure with preserved LVEF (>50%) in stable condition, group 2 (HTN) enrolled 46 hypertensive patients, and group 3 (CON) represented the control group consisting of 40 age-matched subjects
It was shown in a study that included 266 consecutive healthy subjects without cardiovascular risk factors, with a mean age of 39.2 ± 17.5 years, where 137 of participants were female, that global and regional longitudinal strain (GLS) (p < 0.001) values were progressively reduced with increasing age, and post hoc intra-group analysis showed that the decline in GLS was significant in the decades 50–60 and ≥60 [25]
Summary
Conventional echocardiographic markers of left ventricular (LV) function, despite their widespread use in current diagnostic and management guidelines of heart failure (HF) [1], have significant disadvantages, especially because recently HF with preserved ejection fraction (HFpEF, LVEF ≥ 50%) became the dominant presentation [2], requiring a reliable assessment of LV function. Global longitudinal strain (GLS) assessment by 2D STE has become a clinically feasible alternative to ejection fraction for quantifying myocardial function. Contribution of global and regional longitudinal strain (GLS) for clinical assessment of patients with heart failure with preserved ejection fraction (HFpEF) is not well established. Regional (basal, mid, and apical), and global longitudinal strain were assessed for each study group using two-dimensional speckle-tracking echocardiography (2D-STE). Conclusions: Global longitudinal strain can be used for clinical assessment in differentiating coronary and hypertensive patients at higher risk for development of systolic dysfunction
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
