New echocardiographic parameters in the diagnosis of heart failure with preserved ejection fraction

2017 ◽  
Vol 34 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Monika Špinarová ◽  
Jaroslav Meluzín ◽  
Helena Podroužková ◽  
Radka Štěpánová ◽  
Lenka Špinarová
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction ◽  
Echocardiographic Parameters

scholarly journals Non-invasive intraventricular pressure differences estimated with cardiac MRI in subjects without heart failure and with heart failure with reduced and preserved ejection fraction

Open Heart ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. e001088 ◽  
Author(s):  
Francisco Londono-Hoyos ◽  
Patrick Segers ◽  
Zeba Hashmath ◽  
Garrett Oldland ◽  
Maheshwara Reddy Koppula ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Systolic Function ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Spatiotemporal Pattern ◽  
Intraventricular Pressure ◽  
Preserved Ejection Fraction ◽  
Non Invasive ◽  
Echocardiographic Parameters

ObjectiveNon-invasive assessment of left ventricular (LV) diastolic and systolic function is important to better understand physiological abnormalities in heart failure (HF). The spatiotemporal pattern of LV blood flow velocities during systole and diastole can be used to estimate intraventricular pressure differences (IVPDs). We aimed to demonstrate the feasibility of an MRI-based method to calculate systolic and diastolic IVPDs in subjects without heart failure (No-HF), and with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).MethodsWe studied 159 subjects without HF, 47 subjects with HFrEF and 32 subjects with HFpEF. Diastolic and systolic intraventricular flow was measured using two-dimensional in-plane phase-contrast MRI. The Euler equation was solved to compute IVPDs in diastole (mitral base to apex) and systole (apex to LV outflow tract).ResultsSubjects with HFpEF demonstrated a higher magnitude of the early diastolic reversal of IVPDs (−1.30 mm Hg) compared with the No-HF group (−0.78 mm Hg) and the HFrEF group (−0.75 mm Hg; analysis of variance p=0.01). These differences persisted after adjustment for clinical variables, Doppler-echocardiographic parameters of diastolic filling and measures of LV structure (No-HF=−0.72; HFrEF=−0.87; HFpEF=−1.52 mm Hg; p=0.006). No significant differences in systolic IVPDs were found in adjusted models. IVPD parameters demonstrated only weak correlations with standard Doppler-echocardiographic parameters.ConclusionsOur findings suggest distinct patterns of systolic and diastolic IVPDs in HFpEF and HFrEF, implying differences in the nature of diastolic dysfunction between the HF subtypes.

scholarly journals The Prognostic Value of Lung Ultrasound in Patients With Newly Diagnosed Heart Failure With Preserved Ejection Fraction in the Ambulatory Setting

2021 ◽  
Vol 8 ◽  
Author(s):  
Blanka Morvai-Illés ◽  
Nóra Polestyuk-Németh ◽  
István Adorján Szabó ◽  
Magdolna Monoki ◽  
Luna Gargani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Predictive Value ◽  
Lung Ultrasound ◽  
Adverse Outcomes ◽  
Ambulatory Setting ◽  
Preserved Ejection Fraction ◽  
Newly Diagnosed ◽  
Echocardiographic Parameters ◽  
B Lines

Background: Heart failure with preserved ejection fraction (HFpEF) is a growing healthcare burden, and its prevalence is steadily increasing. Lung ultrasound (LUS) is a promising screening and prognostic tool in the heart failure population. However, more information on its value in predicting outcome is needed.Aims: The aim of our study was to assess the prognostic performance of LUS B-lines compared to traditional and novel clinical and echocardiographic parameters and natriuretic peptide levels in patients with newly diagnosed HFpEF in an ambulatory setting.Methods: In our prospective cohort study, all ambulatory patients with clinical suspicion of HFpEF underwent comprehensive echocardiography, lung ultrasound and NT-proBNP measurement during their first appointment at our cardiology outpatient clinic. Our endpoint was a composite of worsening heart failure symptoms requiring hospitalization or loop diuretic dose escalation and death.Results: We prospectively enrolled 75 consecutive patients with HFpEF who matched our inclusion and exclusion criteria. We detected 11 events on a 26 ± 10-months follow-up. We found that the predictive value of B-lines is similar to the predictive value of NT-proBNP (AUC 0.863 vs. 0.859), with the best cut-off at >15 B-lines. Having more B-lines than 15 significantly increased the likelihood of adverse events with a hazard ratio of 20.956 (p = 0.004). The number of B-lines remained an independent predictor of events at multivariate modeling. Having more than 15 B-lines lines was associated with a significantly worse event-free survival (Log-rank: 16.804, p < 0.001).Conclusion: The number of B-lines seems to be an independent prognostic factor for adverse outcomes in HFpEF. Since it is an easy-to-learn, feasible and radiation-free method, it may add substantial value to the commonly used diagnostic and risk stratification models.

scholarly journals The prognostic value of B-lines in heart failure with preserved ejection fraction

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
N Nemeth ◽  
B Morvai-Illes ◽  
I Szabo ◽  
L Gargani ◽  
A Varga ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Lung Ultrasound ◽  
Diuretic Therapy ◽  
Adverse Outcomes ◽  
Preserved Ejection Fraction ◽  
Funding Sources ◽  
Echocardiographic Parameters ◽  
B Lines

Abstract Funding Acknowledgements Type of funding sources: None. Background  Heart Failure with Preserved Ejection Fraction (HFpEF) is a growing healthcare burden, and its prevalence is steadily increasing. Despite its common occurrence, HFpEF remained a challenge in every aspect. The evaluation of B-lines with lung ultrasound (LUS) is a promising diagnostic and prognostic tool in this population. Objectives The aim of our study was to assess the diagnostic and prognostic performance of B-lines compared with traditional clinical, echocardiographic parameters and natriuretic peptide levels in patients with clinical suspicion of HFpEF. Methods 78 consecutive patients (70.45 ± 6.75 years, 72% female) with suspected HFpEF were prospectively enrolled. Exclusion criteria were: ejection fraction ≤55%, more than mild mitral and/or aortic valve disease, cardiomyopathy, pulmonary disease, pulmonary arterial hypertension, renal failure and anemia. All patients underwent comprehensive echocardiography, lung ultrasound exam and NT-proBNP measurement during their first appointment. Our endpoint was a composite of acute heart failure (HF),  hospitalization for the worsening HF symptoms and intensification of diuretic therapy. Also, traditional major cardiac adverse events such as death, myocardial infarction, stroke and revascularization were collected. Results We detected 11 events during 12 ± 6 months follow up. The number of B-lines showed a good correlation with NT-proBNP levels (p < 0,001, r = 0.693). B-lines were found to have similar performance to NT-proBNP in predicting events (AUC = 0.778 vs. 0.770, respectively). Those who had more than 30 B-lines on LUS had significantly worse event-free survival p = 0.004. Having more than 30 B-lines at baseline was associated with 7 times greater hazard of adverse outcomes. Conclusions LUS is a simple, feasible tool to detect pulmonary congestion in patients with HFpEF. In our prospective cohort study, LUS was found to be a useful tool for prognostic stratification. Abstract Figure. Prognostic value of B-lines

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