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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Attenuation of stress-based ventricular contractility in patients with heart failure and normal ejection fraction

Liang Zhong1, Kian Keong Poh, Li Ching Lee

  • 1Department of Cardiology, National Heart Centre, Singapore.

Annals of the Academy of Medicine, Singapore
|June 17, 2011
PubMed

Insights

The maximal rate of change of pressure-normalised wall stress (dσ*/dtmax) effectively diagnoses heart failure with normal ejection fraction (HFNEF). This echocardiographic measure is a powerful predictor, aiding early diagnosis and management of HFNEF.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Diagnostic Imaging

Background:

  • The maximal rate of change of pressure-normalised wall stress (dσ*/dtmax) is a proposed index of left ventricular (LV) contractility.
  • Heart failure with normal ejection fraction (HFNEF) presents diagnostic challenges.

Purpose of the Study:

  • To assess the diagnostic capacity of dσ*/dtmax for identifying HFNEF.
  • To evaluate dσ*/dtmax as a predictor of heart failure with reduced ejection fraction (HFREF) and HFNEF.

Main Methods:

  • Echocardiography was used to measure dσ*/dtmax in 100 healthy controls, 40 HFNEF patients, and 100 HFREF patients.
  • Exclusion criteria included significant valvular heart disease; Tissue Doppler indices were also measured.

Main Results:

  • dσ*/dtmax was significantly reduced in HFNEF (3.02 ± 0.98 s⁻¹) and HFREF (2.00 ± 0.67 s⁻¹) compared to controls (4.43 ± 1.27 s⁻¹).
  • dσ*/dtmax independently predicted both HFNEF and HFREF.
  • Receiver operating characteristic analysis showed high accuracy for detecting HFNEF (AUC 0.84) and HFREF (AUC 0.88).

Conclusions:

  • dσ*/dtmax is a powerful independent predictor for diagnosing HFNEF via echocardiography.
  • This measure can aid in the early diagnosis, triage, and management of HFNEF patients.
Abstract

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