Detecting heart failure in severe asthma patients using speckle tracking echocardiography

To determine the presence of acute myocardial dysfunction in status asthmaticus.

From 2006 to 2025, we studied severe asthma patients, healthy controls, and weightlifters performing bench press. Group differences were evaluated using echocardiography with Speckle Tracking by velocity vector imaging (VVI). Asthma patients were followed for 6 months.

Of 357 participants, 169 were controls. The median age of asthmatic patients (n = 188) was 58.11 ± 12.97 years, comparable to controls. Thirty-one patients died. All patients with severe asthma demonstrated reduced biventricular strain. After bench press, all echocardiographic values were higher compared to non-sportsmen and asthmatic patients. Acute asthma patients demonstrated lower strain in the four cavities, and more asynchrony versus controls. Right ventricular global longitudinal strain was ([- 27.56 ± 4.56] in the control group, [- 24.08 ± 1.23] in the basal weightlifters' group, [- 30.88 ± 1.02] after bench press and [- 17.98 ± 2.57] in severe asthma, p value = 0.0001). Left ventricular global longitudinal strain (%) were (- 21.02 ± 3.28, - 19.34 ± 3.78, - 25.21 ± 9.32, - 14.88 ± 1.27, p value = 0.012) respectively. Multivariate analysis identified right atrial pump strain (OR 0.457 [0.189-0.746]) and as factors associated with mortality. Mechanical Ventilation was associated with RVGLS (OR 0.637, CI 95% [0.248-0.925]) and right atrial pump strain (OR 0.783, CI 95% [0.349-0.967]). At 6 months follow-up, asthmatic patients exhibited lower deformity parameters and decreased Speckle Tracking vectorial velocity analysis in all cardiac chambers compared to control groups.

Patients with acute asthma exhibit decreased strain in all cardiac chambers, which remains reduced at the six-month follow-up. Asthma may contribute to latent heart failure.