Related Experiment Videos
D V Vdovenko1, I A Libov, R A Libis
1Orenburg Medical State University.. fake@neicon.ru.
Insights
Chronic heart failure with preserved ejection fraction (PEF) shows diastolic dysfunction and reduced left ventricular strain, particularly in basal segments. These findings highlight subtle yet significant myocardial alterations in PEF patients.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Imaging
Background:
- Chronic heart failure with preserved ejection fraction (CHF-PEF) affects a significant patient population.
- Understanding myocardial function in CHF-PEF is crucial for diagnosis and management.
- Traditional echocardiography may not fully capture subtle functional changes in CHF-PEF.
Purpose of the Study:
- To investigate myocardial function in patients with CHF-PEF using advanced echocardiographic techniques.
- To assess left ventricular diastolic function and strain parameters in CHF-PEF.
- To correlate strain findings with clinical characteristics in CHF-PEF.
Main Methods:
- Speckle tracking echocardiography and tissue Doppler imaging were employed.
- Eighty patients with CHF-PEF (NYHA class I-IIa) and 35 healthy controls were studied.
- Left ventricular ejection fraction, diastolic function, global longitudinal strain (GLS), and segmental strain were analyzed.
Main Results:
- All CHF-PEF patients exhibited left ventricular diastolic dysfunction (abnormal relaxation or pseudonormal patterns).
- Reduced global longitudinal strain (GLS) and GLS rate were observed in CHF-PEF patients.
- Basal anteroseptal and anterolateral segments showed the most pronounced reduction in strain and strain rate.
Conclusions:
- Patients with CHF-PEF demonstrate significant alterations in diastolic function.
- Global and segmental left ventricular strain are reduced in CHF-PEF, with specific regional vulnerabilities.
- Speckle tracking echocardiography is valuable for detecting myocardial dysfunction in CHF-PEF.
Aim:
to study myocardial function in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction (PEF) by speckle tracking echocardiography and tissue doppler imaging.
Materials And Methods:
We examined 80 patients aged 50-70 years with verified NYHA class I-IIa CHF and PEF due to arterial hypertension and ischemic heart disease, and 35 healthy persons. Examination included echocardiography, and speckle-tracking echocardiography.
Results:
According to 6-min walk test 26.9 % of patients had functional class (FC) I CHF, 48.3 % - FC II CHF, and 24.8 - FC III CHF. The mean left ventricular ejection fraction (Simpson's method) was 62.3±5.35 %, mean end systolic left atrial volume index - 45±8.1 ml / m2. All patients had left ventricular diastolic dysfunction: 60 patients - abnormal relaxation pattern, 20 patients - pseudonormal pattern. Other findings were reduced global longitudinal strain (GLS, -16.56±2.61 %) and GLS rate (GLSR, -0.75±0.11 s-1) of the left ventricle and reduced segmental strain and strain rate in basal anteroseptal (-13.62±3.44 % and -0.77±0.04 s-1, respectively) and basal anterolateral (-14.17±3.31 % and -0.81±0.11 s-1, respectively) segments. Lowering of global circular left ventricular strain and strain rate (-15.63±4.8% and -1.4±0.23 s-1, respectively) was found to be smaller than that of GLS (p<0.05). There was positive correlation between left ventricular systolic GLS and left atrial volume (r=0.601, р<0.01).
Conclusions:
In patients with CHF and PEF we revealed alterations of diastolic function (abnormal relaxation and pseudonormal patterns), reductions of global and segmental strain and strain rate of the left ventricle. More pronounced lowering of segmental strain and strain rate was registered in left ventricular basal anteroseptal and basal anterolateral segments. Circular strain was found to be slightly reduced, while radial strain was unchanged.