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Very early stage left ventricular endocardial dysfunction of patients with hypereosinophilic syndrome

Tetsushi Yamamoto1, Hidekazu Tanaka2, Chiyo Kurimoto1

  • 1Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan.

The International Journal of Cardiovascular Imaging
|June 1, 2016
PubMed

Insights

Early cardiac damage in hypereosinophilic syndrome (HES) is detectable. Global longitudinal strain (GLS) using 2D speckle-tracking identifies left ventricular endocardial dysfunction in HES patients before apparent heart involvement.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Imaging

Background:

  • Cardiac involvement in hypereosinophilic syndrome (HES) significantly increases morbidity and mortality.
  • Left ventricular (LV) endocardial damage is a key factor in HES cardiac complications.
  • Detecting very early-stage LV endocardial damage before overt cardiac symptoms is crucial for timely intervention.

Purpose of the Study:

  • To investigate subclinical left ventricular (LV) endocardial dysfunction in HES patients with normal conventional echocardiograms.
  • To evaluate the utility of global longitudinal strain (GLS) in identifying early-stage cardiac involvement in HES.

Main Methods:

  • Studied 32 HES patients and 31 matched healthy controls with normal echocardiograms.
  • Utilized 2D speckle-tracking to measure global radial, circumferential, and longitudinal strain (GRS, GCS, GLS).
  • Performed receiver operating characteristic (ROC) curve analysis to determine GLS predictive value for LV endocardial dysfunction.

Main Results:

  • While GRS and GCS were similar between groups, HES patients showed significantly lower GLS (16.2 ± 3.3% vs 19.3 ± 2.9%, p < 0.001).
  • GLS ≤17.0% was identified as the optimal predictor of LV endocardial dysfunction (AUC=0.781, sensitivity=66%, specificity=78%).
  • LV endocardial dysfunction was present in HES patients even without apparent cardiac involvement.

Conclusions:

  • Subclinical LV endocardial dysfunction precedes overt cardiac involvement in HES.
  • Two-dimensional speckle-tracking derived GLS is a valuable tool for detecting very early cardiac changes in HES patients.
  • Early detection of LV dysfunction can improve management strategies for HES patients.

Keywords:
EchocardiographyGlobal longitudinal strainHypereosinophilic syndromeLeft ventricular endocardial dysfunction

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