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Myocardial contractile dysfunction associated with increased 3-month and 1-year mortality in hospitalized patients

Liang Zhong1, Kenneth K C Ng, Ling Ling Sim

  • 1National Heart Centre Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore.

International Journal of Cardiology
|January 23, 2013
PubMed

Insights

Heart failure with preserved ejection fraction (HFPEF) patients show reduced left ventricular (LV) contractility. A depressed regional contractility index predicts higher mortality in HFPEF, highlighting its clinical significance.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Clinical need for contractility index in heart failure with preserved ejection fraction (HFPEF).
  • Myocardial contractile dysfunction can occur even with preserved ejection fraction (EF).
  • Novel load-independent indices assess global and regional left ventricular (LV) contractility.

Purpose of the Study:

  • Compare LV contractile function in HFPEF, heart failure with reduced ejection fraction (HFREF), and normal subjects.
  • Evaluate novel contractility indices.
  • Determine associations between contractility parameters and mortality in HFPEF patients.

Main Methods:

  • Recruited 199 HFPEF patients, 327 HFREF patients, and 22 normal controls.
  • Utilized standard two-dimensional Doppler and tissue Doppler echocardiography.
  • Characterized LV dimensions, structure, global, and regional contractile function.

Main Results:

  • Reduced global LV contractility index (dσ*/dtmax) in HFPEF and HFREF compared to normal subjects.
  • Reduced regional LV contractility index in HFPEF and HFREF compared to normal subjects.
  • In HFPEF, a regional contractility index (sc-mFS <76%) predicted 3-month and 1-year mortality.

Conclusions:

  • HFPEF patients exhibit decreased LV global and regional contractility.
  • Depressed regional contractility index is linked to increased mortality in HFPEF.
  • Novel contractility indices offer valuable prognostic information in heart failure.
Abstract

Keywords:
ContractilityHeart failureNormalized wall-stressPathophysiologyPrognosis

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