Left ventricular strain-volume loops and diastolic dysfunction in suspected heart failure with preserved ejection fraction

被引：5

作者：

Kerstens, Thijs P. ^{[1
]}

Weerts, Jerremy ^{[3
]}

van Dijk, Arie P. J. ^{[2
]}

Weijers, Gert ^{[4
]}

Knackstedt, C. ^{[3
]}

Eijsvogels, Thijs M. H. ^{[1
]}

Oxborough, David ^{[5
]}

van Empel, Vanessa P. M. ^{[3
]}

Thijssen, Dick H. J. ^{[1
,5
,6
]}

机构：

[1] Radboud Univ Nijmegen Med Ctr, Dept Med Biosci, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands

[2] Radboud Univ Nijmegen Med Ctr, Dept Cardiol, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands

[3] Maastricht Univ Med Ctr MUMC, Cardiovasc Res Inst Maastricht CARIM, Dept Cardiol, P Debyepl 25, NL-6200 MD Maastricht, Netherlands

[4] Radboud Univ Nijmegen Med Ctr, Med UltraSound Imaging Ctr MUS, Dept Radiol & Nucl Med, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands

[5] Liverpool John Moores Univ, Res Inst Sport & Exercise Sci, Liverpool L3 5UX, England

[6] Radboud Univ Nijmegen Med Ctr, Dept Physiol 928, POB 9101, NL-6500 HB Nijmegen, Netherlands

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2023年 / 378卷

关键词：

Strain volume loop; Diastolic dysfunction; Echocardiography; Speckle tracking imaging; AREA LOOP; EUROPEAN ASSOCIATION; FILLING PRESSURES; AMERICAN SOCIETY; ECHOCARDIOGRAPHY; RECOMMENDATIONS; GUIDELINES; DIAGNOSIS; PATHOPHYSIOLOGY; PROGRESSION;

D O I：

10.1016/j.ijcard.2023.01.084

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Presence of left ventricular diastolic dysfunction (DD) is key in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). However, non-invasive assessment of diastolic function is complex, cumbersome, and largely based on consensus recommendations. Novel imaging techniques may help detecting DD. Therefore, we compared left ventricular strain-volume loop (SVL) characteristics and diastolic (dys-)function in suspected HFpEF patients.Method and results: 257 suspected HFpEF patients with sinus rhythm during echocardiography were prospectively included. 211 patients with quality-controlled images and strain and volume analysis were classified according to the 2016 ASE/EACVI recommendations. Patients with indeterminate diastolic function were excluded, resulting in two groups: normal diastolic function (control; n = 65) and DD (n = 91). Patients with DD were older (74.8 +/- 6.9 vs. 68.5 +/- 9.4 years, p < 0.001), more often female (88% vs 72%, p = 0.021), and more often had a history of atrial fibrillation (42% vs. 23%, p = 0.024) and hypertension (91% vs. 71%, p = 0.001) compared to normal diastolic function. SVL analysis showed a larger uncoupling i.e., a different longitudinal strain contribution to volume change, in DD compared to controls (0.556 +/- 1.10% vs.-0.051 +/- 1.14%, respectively, P < 0.001). This observation suggests different deformational properties during the cardiac cycle. After adjustment for age, sex, history of atrial fibrillation and hypertension, we found an adjusted odds ratio of 1.68 (95% confidence interval 1.19-2.47) for DD per unit increase in uncoupling (range: -2.95-3.20).Conclusion: Uncoupling of the SVL is independently associated with DD. This might provide novel insights in cardiac mechanics and new opportunities to assess diastolic function non-invasively.

引用

页码：144 / 150

页数：7