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[Structural and Functional Characteristics of the Heart in Patients With "Constrictive", "Pseudo-Normal" and

A G Obrezan1, D N Perutskiy2

  • 1Federal State Budgetary Educational Institution of Higher Education "Saint-Petersburg State University".

Kardiologiia
|October 27, 2018
PubMed

Insights

Stress echocardiography reveals elevated left ventricular filling pressures in patients with diastolic dysfunction, indicating deeper cardiovascular changes and reduced heart function. This aids in diagnosing heart failure with preserved ejection fraction.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Diastolic Function

Background:

  • Diastolic dysfunction (DF) is a key factor in heart failure with preserved ejection fraction (HFpEF).
  • Assessing structural-functional heart characteristics in various DF types is crucial for accurate diagnosis and management.
  • Stress echocardiography (EchoCG) combined with myocardial deformation analysis offers insights into cardiac mechanics under stress.

Purpose of the Study:

  • To investigate the structural and functional heart characteristics in patients with different types of diastolic dysfunction.
  • To utilize stress echocardiography and myocardial deformation parameters to evaluate these characteristics.
  • To correlate findings with clinical conditions like hypertensive disease and chronic heart failure.

Main Methods:

  • 110 patients with hypertensive disease, chronic heart failure, and abnormal diastolic function (without coronary stenosis) were studied.
  • Standard clinical evaluation, echocardiography with 3D global longitudinal strain (GLS), and stress EchoCG were performed.
  • Diastolic function parameters and myocardial deformation indices were assessed during stress.

Main Results:

  • Elevated left ventricular (LV) filling pressures during stress EchoCG indicated non-homogeneity among DF groups.
  • Patients with higher LV filling pressures showed reduced left atrial (LA) passive emptying fraction and distensibility.
  • Despite varying DF types, LV contractility reduction and 3D GLS were similar, suggesting underlying structural changes.

Conclusions:

  • Stress EchoCG revealing elevated LV filling pressures highlights deeper cardiovascular changes, reduced myocardial contractility, and impaired LA function.
  • Integrating stress EchoCG with myocardial deformation analysis improves HFpEF diagnostics.
  • This approach helps identify preclinical manifestations of heart failure.
Abstract

Keywords:
chronic heart failureleft ventricular ejection fractionmyocardial deformationstress echocardiography

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