1040 Unexpected prevalence of subtle systolic and diastolic dysfunction in genotype-positive phenotype-negative relatives of dilated cardiomyopathy patients

Abstract Funding Acknowledgements None Background Left ventricular global longitudinal strain (LV-GLS) and peak left atrial longitudinal strain (PALS) are promising techniques for the detection of a subtle systolic and diastolic dysfunction for an early diagnosis of genetically determined dilated cardiomyopathy (DCM). Purpose. We sought to evaluate the prevalence of subtle systolic and diastolic dysfunction by LV-GLS and PALS in a cohort of genotype-positive phenotype-negative (GPFN) DCM relatives. Methods. We analysed echocardiograms (including LV-GLS and PALS) of 41 GPFN relatives of DCM patients (GPFN group - 37 ± 14 years, 48.8% male). They were compared with a matched group of 52 healthy individuals (control group). Reduced LV-GLS and PALS were defined as >-18% and <23.1%, respectively, according to literature data. Results. GPFN and control groups were grossly similar according to standard echocardiographic measurements. Conversely, mean LV-GLS was -18.8 ± 2.7% in the GPFN group vs. -24.0 ± 1.8% in the control group (p < 0.001). 20 subjects (48.8%) in the GPFN group and no subjects in the control group had a reduced LV-GLS. The mean PALS was 29.2 ± 6.7% in the GPFN group vs. 40.8 ± 8.5% in the control group (p < 0.001). 7 subjects (18.4%) in the GPFN group and one (2%) in the control group had a reduced PALS. During a median follow-up of 27 months, 6 (14.6%) GPFN relatives developed a LV ejection fraction <50%. Among them, 4 (66%) had a reduced LV-GLS at initial evaluation. Conclusions. LV-GLS and PALS are impaired in GPFN relatives of DCM patients compared to healthy individuals, when standard echocardiographic parameters are normal. Further studies are warranted to add prognostic significance to this result, which may lead in the future to an early therapy initiation. Abstract 1040 Figure. Mean LV-GLS and PALS in GPFN and control

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Contribution of Global and Regional Longitudinal Strain for Clinical Assessment of HFpEF in Coronary and Hypertensive Patients

Medicina ◽

10.3390/medicina57121372 ◽

2021 ◽

Vol 57 (12) ◽

pp. 1372

Author(s):

Gheorghe Stoichescu-Hogea ◽

Florina Nicoleta Buleu ◽

Ruxandra Christodorescu ◽

Raluca Sosdean ◽

Anca Tudor ◽

...

Keyword(s):

Diastolic Dysfunction ◽

Clinical Assessment ◽

Longitudinal Strain ◽

Systolic Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

Hypertensive Patients ◽

Group 2 ◽

Artery Disease

Background: Contribution of global and regional longitudinal strain (GLS) for clinical assessment of patients with heart failure with preserved ejection fraction (HFpEF) is not well established. We sought to evaluate subclinical left ventricular dysfunction secondary to coronary artery disease (CAD) in HFpEF patients compared with hypertensive patients and age-matched healthy subjects. Material and methods: This was a retrospective study that included 148 patients (group 1 = 62 patients with HFpEF, group 2 = 46 hypertensive patients, and group 3 = 40 age-matched control subjects). Peak systolic segmental, regional (basal, mid, and apical), and global longitudinal strain were assessed for each study group using two-dimensional speckle-tracking echocardiography (2D-STE). Results: GLS values presented statistically significant differences between the three groups (p < 0.001); markedly increased values (more negative) were observed in the control group (−20.2 ± 1.4%) compared with HTN group values (−18.4 ± 3.0%, p = 0.031) and with HFpEF group values (−17.6 ± 2.3%, p < 0.001). The correlation between GLS values and HTN stages was significant, direct, and average (Spearman coefficient rho = 0.423, p < 0.001). GLS had the greatest ability to detect patients with HFpEF when HFpEF + CAD + HTN diastolic dysfunction (n = 30) + CON diastolic dysfunction (n = 2) from HFpEF + CAD + HTN + CON was analyzed. (optimal GLS limit of −19.35%, area under curve = 0.833, p < 0.001). Conclusions: Global longitudinal strain can be used for clinical assessment in differentiating coronary and hypertensive patients at higher risk for development of systolic dysfunction.

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Prognostic significance of longitudinal strain in dilated cardiomyopathy with recovered ejection fraction

Heart ◽

10.1136/heartjnl-2021-319504 ◽

2021 ◽

pp. heartjnl-2021-319504

Author(s):

Marco Merlo ◽

Marco Masè ◽

Andrew Perry ◽

Eluisa La Franca ◽

Elena Deych ◽

...

Keyword(s):

Ejection Fraction ◽

Dilated Cardiomyopathy ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Prognostic Significance ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Risk Of Death

ObjectivePatients with non-ischaemic dilated cardiomyopathy (NICM) may experience a normalisation in left ventricular ejection fraction (LVEF). Although this correlates with improved prognosis, it does not correspond to a normalisation in the risk of death during follow-up. Currently, there are no tools to risk stratify this population. We tested the hypothesis that absolute global longitudinal strain (aGLS) is associated with mortality in patients with NICM and recovered ejection fraction (LVEF).MethodsWe designed a retrospective, international, longitudinal cohort study enrolling patients with NICM with LVEF <40% improved to the normal range (>50%). We studied the relationship between aGLS measured at the time of the first recording of a normalised LVEF and all-cause mortality during follow-up. We considered aGLS >18% as normal and aGLS ≥16% as of potential prognostic value.Results206 patients met inclusion criteria. Median age was 53.5 years (IQR 44.3–62.8) and 56.6% were males. LVEF at diagnosis was 32.0% (IQR 24.0–38.8). LVEF at the time of recovery was 55.0% (IQR 51.7–60.0). aGLS at the time of LVEF recovery was 13.6%±3.9%. 166 (80%) and 141 (68%) patients had aGLS ≤18% and <16%, respectively. During a follow-up of 5.5±2.8 years, 35 patients (17%) died. aGLS at the time of first recording of a recovered LVEF correlated with mortality during follow-up (HR 0.90, 95% CI 0.91 to 0.99, p=0.048 in adjusted Cox model). No deaths were observed in patients with normal aGLS (>18%). In unadjusted Kaplan-Meier survival analysis, aGLS <16% was associated with higher mortality during follow-up (31 deaths (22%) in patients with GLS <16% vs 4 deaths (6.2%) in patients with GLS ≥16%, HR 3.2, 95% CI 1.1 to 9, p=0.03).ConclusionsIn patients with NICM and normalised LVEF, an impaired aGLS at the time of LVEF recovery is frequent and associated with worse outcomes.

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P775 Assessment of left ventricular function in patients with atrial fibrillation using real time triplain speckle tracking in comparison with 2D speckle tracking

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.434 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

HASAN Ali Al-Farhan ◽

T A Sulaiman

Keyword(s):

Atrial Fibrillation ◽

Ejection Fraction ◽

Real Time ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Systolic Dysfunction ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Control Group ◽

And Control

Abstract Background Atrial fibrillation (AF) is one of the most common cardiovascular diseases in the world, can cause many structural and functional cardiac abnormalities, one of them is left ventricular (LV) systolic dysfunction which may not be detected by conventional echocardiographic parameters (CEP) and need to use a modality of real time triplain (3P) speckle tracking strain for early detection and improvement of prognosis Purpose Assessment of LV systolic function in AF patients with normal ejection fraction (EF) using 3P speckle-tracking strain and its role as early predictor of subclinical dysfunction Methods A case-control study was conducted at Baghdad Heart Center, Baghdad Medical City since July 2017 to July 2018, including patients with AF and control group. The CEP (EF, diastolic function, mitral annular plane systolic excursion) and speckle tracking longitudinal strain were done for the patients by 3P in comparison with two dimension (2D) Results The study included two groups. First group: 100 patients with AF, mean age (48 ± 12.2) ranging between (25-81), (48%) men, (52%) women. Second group: 100 control patients with mean age (46.4 ± 13.1) ranging between (20-84), (58%) men, (42%) women. 3P method showed more easy and accurate in comparison with 2D method in patients with AF. Applying cut off value of (-17.5%), it was found that 71% of AF patients had undetected LV systolic dysfunction even with preserved EF. Global longitudinal strain was reduced significantly in those with AF group and reduced mitral annular plane systolic excursion Conclusion(s) Real time triplain speckle tracking can be dependable which is easy, useful, and more accurate in comparison with 2D method in assessment of LV function in patients with AF. 3P method is a useful tool in the early detection of subtle LV systolic dysfunction in AF patients with preserved EF and in whom more aggressive interventions could have a significant impact on prognosis. 3P vs 2D in Patients with AF and Control Average GLS by 3P % Average GLS by 2D % p-value No. Mean± SD No. Mean± SD AF group EF < 52 % 29 -11.23± 3.89 29 -12.05± 3.84 0.01 EF ≥53 % 71 -13.30± 2.55 71 -14.20± 2.64 0.001 Control group EF < 52 % 2 -21.15± 4.45 2 -20.20± 1.84 0.6 EF ≥53 % 98 -19.14± 1.49 98 -19.91± 1.66 0.001 3P, real time triplain; 2D, two dimension; AF, atrial fibrillation; GLS, global longitudinal strain; SD, standard deviation; EF, ejection fraction

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Evaluation of Left Ventricular Function in Polymyositis and Dermatomyositis Patients with Global Longitudinal Strain Using Two Dimensional Speckle Tracking Method

10.32592/ircmj.2021.23.8.771 ◽

2021 ◽

Keyword(s):

Diastolic Dysfunction ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Control Group ◽

Two Dimensional ◽

Ventricular Ejection Fraction ◽

Significant Difference

Background: Heart problems are one of the main causes of death in patients with idiopathic inflammatory myopathies, such as polymyositis (PM) and dermatomyositis (DM). Speckle tracking echocardiography (STE) and global longitudinal strain (GLS) are non-invasive, accurate, repeatable, and angle-independent imaging techniques that facilitate a full global and regional evaluation of the left ventricular (LV) function. Objectives: This study aimed to evaluate myocardial dysfunction in DM and PM patients using STE and GLS methods. Methods: The present control-case study was conducted on 30 polymyositis and dermatomyositis patients and 40 healthy people as the control group. Both groups showed no symptoms of cardiovascular diseases. Both groups underwent two-dimensional STE and GLS evaluation. The GLS value was taken as a marker of LV systolic dysfunction. Results: The 2D GLS value of LV was significantly lower in the DM and PM patients, compared to the control group. A mild diastolic dysfunction was observed in seven (23.3%) patients, and 23 (76.7%) patients had a normal state. The patients’ age and duration of the disease were found to be significantly correlated with the left ventricular diastolic dysfunction. No significant difference was observed between the DM and PM patients with the control group in terms of pulmonary artery pressure level. Conclusion: Although the DM and PM patients had normal left ventricular ejection fraction values, there was a significant difference between the patients in these two groups and the control group in terms of LV dysfunction using GLS. Therefore, GLS is a useful variable that can be used to diagnose sustained and subclinical disorders in LV systolic function of DM and PM patients.

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Abstract 15928: Relative Sparing of Apical Longitudinal Strain for Detection of Cardiac Amyloidosis: Intervendor Variation

Circulation ◽

10.1161/circ.142.suppl_3.15928 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Julia M Simkowski ◽

Michael Jiang ◽

NADIA El HANGOUCHE ◽

Jeesoo Lee ◽

Milica Marion ◽

...

Keyword(s):

Cardiac Amyloidosis ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

High Sensitivity ◽

High Specificity ◽

Left Ventricular ◽

Control Group ◽

Lower Sensitivity ◽

Medical Systems ◽

Roc Curve Analysis

Introduction: Relative apical longitudinal strain (RALS) is defined as (average apical LS/(average basal & mid-ventricular LS)). A threshold of 2 has been found to have high sensitivity and specificity for differentiating cardiac amyloidosis (CA) from other causes of left ventricular hypertrophy (LVH). This threshold was developed using General Electric (GE) software, and its reproducibility among different software vendors is unknown. Hypothesis: In patients with CA, regional segmental LS patterns and relative apical longitudinal strain will vary among software vendors. Methods: Speckle-tracking echocardiography was retroactively performed by an experienced technician on two patient cohorts, CA (n=52) and LVH (n=52), using software from two independent vendors: EchoPAC (GE Medical Systems) and TomTEC (TOMTEC Imaging Systems GMBH). For each vendor and patient, strain values for the basal, mid, and apical segments were averaged to obtain three regional LS values which were then used to calculate global longitudinal strain (GLS) and RALS. Results: EchoPAC demonstrated greater average apical LS (-16.5±5.7 vs -13.1±6.6, p<0.001) and RALS (2.1±0.9 vs 1.7±0.7, p<0.001) compared to TomTEC. Bland-Altman analysis yielded a mean bias of -0.4 with limit of agreement 2.2 (p<0.001) in RALS between the two vendors. ROC curve analysis using a RALS cutoff of 2 to differentiate CA from the overall control group showed similarly high specificity (EchoPAC 85%, TomTEC 83%) between vendors but lower sensitivity for TomTEC (23% vs 45%) (Figure 1). LVH subgroup analysis showed similar comparisons. Overall difference in area-under-curve (AUC) was significant (AUC = 0.78 EchoPAC vs AUC = 0.52 TomTEC, p < 0.001). Conclusions: Software measurements of regional LS and thus RALS vary between vendors. Further efforts are needed for intervendor regional strain fidelity. For now, different RALS thresholds to diagnose CA may be needed for various vendors.

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1187 Evaluation of left and right ventricular functions with 3D speckle tracking in patients with mitral stenosis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.686 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

O Seckin ◽

S Unlu ◽

G Tacoy

Keyword(s):

Right Ventricular ◽

Mitral Stenosis ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Three Dimensional ◽

Left Ventricular ◽

Control Group ◽

Free Wall ◽

Significant Difference

Abstract Background The function of both ventricles have been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricles (LV) in mild and moderate rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). Methods A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. An example for RV assessment is shown in Figure 1. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS and interventricular septal (IVS) LS measurements were analyzed. Results The LV ejection fraction (EF), RV fractional area change and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group (ANOVA,p < 0.001) (Table 1). Patients with MS showed higher torsional values, correlated with MS severity (ANOVA,p < 0.001) (Table 1). IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The FW-GLS values only showed significant difference between the control group and moderate MS group (Table 1). Conclusion Patients with mitral stenosis showed lower LV-GLS and higher LV torsion values. Although the LV GLS is affected; the LV EF was detected to be normal due to increase in LV torsion. RV deformation indices showed signıficant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE. Table 1 Parameters Control group Mild MS Moderate MS P LV GLS (%) 23.3 ± 2.08 18.9 ± 1.3 17.5 ± 1.8 <0.001 LV torsion 1.5 ± 0.6 2.1 ± 0.6 2.6 ± 0.5 <0.001 IVS LS (%) 23 ± 3.0% 20 ± 2.6 17.1 ± 2.9 <0.001 RV FW LS (%) 25.4 ± 5 22.7 ± 3.2 21.1 ± 4.8 <0.001 FW; free-wall, GLS; global longitudinal strain, IVS; interventricular septum, LV; left ventricular, RV; right ventricular Abstract 1187 Figure 1

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P621Variation of global longitudinal strain (2D STE) with passive leg lifting maneuver: a marker of myocardial functional reserve?

European Heart Journal ◽

10.1093/eurheartj/ehz747.0229 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M J Nobre De Matos Pereira Vieira ◽

D Campos ◽

M Carrington ◽

L Goncalves ◽

R Teixeira

Keyword(s):

Longitudinal Strain ◽

Contractile Function ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Healthy Population ◽

Healthy Individuals ◽

Functional Reserve ◽

Absolute Increase ◽

Myocardial Disease ◽

Myocardial Functional Reserve

Abstract Introduction In a normal heart, the passive leg lifting maneuver (LLM) will result in an increase in myocardial contractility, according to the mechanistic concept of the Frank-Starling law. With the progression of myocardial disease this ability is impaired and the myocardial functional reserve (mFR) is reduced (Figure1 – Panel A). The variation of left ventricular global longitudinal strain (as an index of contractile function) with LLM may thus represent a marker of left ventricular mFR. Purpose To assess the variation of left ventricular global longitudinal strain (LV GLS) with LLM as a marker of mFR in a healthy population and in patients with myocardial disease (hypertrophic myocardiopathy - HCM and systolic dysfunction patients – SystDysf. Methods and results We evaluated the variation of LV GLS by 2-dimensional Speckle Tracking Echocardiography (2D-STE), in response to passive LLM, in a population of 103 individuals (54 healthy individuals, 28 HCM patients and 21 left ventricular SystDysf patients). Clinical, demographic and echocardiographic parameters (including LV longitudinal mechanics obtained with 2D-STE before and after LLM) were described. The population had a mean age of 46±18 years and 55% were women. Increased venous return to the heart during LLM was confirmed by an increase in the maximal diameter of the inferior vena cava (15,1±3,6 vs 20,6±3,8 mm, p<0.001). There was a significant variation of LV GLS in healthy individuals submitted to LLM (−20,58±3,0 vs −21,5±2,6%, p=0,02, Δ 0,6%, 95% CI 0,1–1,1%). Regarding the HCM and SystDysf groups, no significant change in LV GLS was observed with LLM (−13,2±2,8 vs −12,3±2,9%, p=0,12, Δ +0,6%, 95% CI −1,4 to 0,18% and −10,2±2,5 vs 10,2±2,7%, p=0,79, Δ 0,08%, 95% CI −0,7 to 0,5%, respectively). Figure 1 (Panel B) Conclusion To our knowledge, this is the first report describing the use of LV GLS and LLM to assess mFR in this clinical setting. The absolute increase of LV GLS in the healthy population suggests that this may be a reliable method and a sensitive marker to assess the mFR. Conversely, patients with HCM and with SystDysf show poor or no response to the LLM, suggesting, as expected, a low myocardial functional reserve. Given the non-invasiveness and cost-effectiveness nature of this technique, we suggest that this maneuver could pose a feasible way to assess mFR. Further studies are needed to validate this technique and to assess the role of mFR by 2D-STE as a prognostic marker.

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P1494Usefulness of longitudinal strain adjusted to regional thickness in hypertrophic cardiomyopathy

European Heart Journal ◽

10.1093/eurheartj/ehz748.0258 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

N Mansencal ◽

S Utado ◽

M Hauguelf-Moreau ◽

S Mallet ◽

P Charron ◽

...

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Strain Analysis ◽

Region Of Interest ◽

Left Ventricular ◽

Control Group ◽

Myocardial Wall ◽

Regional Strain ◽

Standard Software

Abstract Background In hypertrophic cardiomyopathy (HCM), longitudinal strain analysis allows to early detect left ventricular (LV) contraction abnormalities despite preserved LV ejection fraction. In current software, the width of the region of interest (ROI) is the same over the entire myocardial wall, and might analyze partially LV hypertrophic segments. Purpose The aim of this study is to evaluate a novel software for strain analysis with an adjustable ROI according to each segment thickness. Methods We included 110 patients: 55 patients with HCM (HCM group) and 55 healthy subjects (age- and sex-matched control group). All patients underwent echocardiography using a Vivid 9 GE system and measurements were performed using EchoPAC software. Global longitudinal strain (GLS) and regional strain for each of the 17 segments was calculated with standard software (for 2 groups) and with software adjusted to the myocardial wall thickness (for HCM group). Results GLS was significantly decreased in the HCM group as compared to the control group (−15.1±4.8% versus −20.5±4.3%, p<0.0001). In HCM group, GLS (standard method versus adjusted to thickness) were not significantly different (p=0.34). Interestingly, regional strain adjusted to thickness was significantly lower than standard strain in hypertrophic segments, especially in basal inferoseptal segment (p=0.0002), median inferoseptal segment (p<0.001) and median anteroseptal segment (p=0.02). Strain adjusted to thickness was still significantly lower in the most hypertrophic segments (≥20 mm) (−3.7±3%, versus −5.9±4.4%, p=0.049 in the basal inferoseptal segment and −5.7±3.5% versus −8.3±4.5%, p=0.0007 in the median inferoseptal segment). Analysis of strain adjusted to thickness had a better feasibility (97.5% versus 99%, p=0.01). Conclusion Analysis of longitudinal strain adjusted to regional thickness is feasible in HCM and allows a better evaluation of myocardial deformation, especially in the most LV hypertrophic segments.

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Abstract 705: The Difference in Left Ventricular Twisting Behavior Between Patients With Hypertensive Heart Disease and Hypertrophic Cardiomyopathy

Circulation ◽

10.1161/circ.118.suppl_18.s_603 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Kazuhisa Nishimura ◽

Hideki Okayama ◽

Makoto Saito ◽

Katsuji Inoue ◽

Toyofumi Yoshii ◽

...

Keyword(s):

Heart Disease ◽

Hypertrophic Cardiomyopathy ◽

Diastolic Dysfunction ◽

Systolic Function ◽

Hypertensive Heart Disease ◽

Left Ventricular ◽

Control Group ◽

Control Groups ◽

The Difference ◽

And Control

(Background) Left ventricular (LV) untwisting behavior is a novel index of LV diastolic function since it is a powerful determinant of LV diastolic suction. The LV of patients with hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) has diastolic dysfunction despite normal systolic function. However, the role of untwisting behavior in HCM and HHD in the pathophysiology of diastolic dysfunction is unknown. The aim of this study was to investigate the difference of LV twisting behavior between patients with HCM and HHD. (Methods) Forty-four patients with HCM (mean age, 63+/−15 y, 34 males), 30 patients with HHD (mean age, 62+/−12 y, 20 males), and 20 age and sex-matched control subjects were evaluated. After a standard echocardiographic examination, LV twist and twisting velocity profiles from apical and basal short-axis images were analyzed using two-dimensional speckle tracking imaging. All temporal parameters were normalized by R-R intervals. (Results) LV diastolic and systolic dimensions, and ejection fraction were not significantly different among the groups. LV mass index and early diastolic mitral annular velocity were not significantly different between the HCM and HHD groups. The peak torsion in the HCM and HHD groups was significantly greater than that in the control group (Table ). The peak untwisting velocity in the HCM group was comparable to that in the control group. However, when the peak untwisting velocity was corrected by peak torsion, the value in the HCM group was significantly decreased compared with that in the HHD and control groups. The time to peak untwisting velocity from aortic valve closure in the HCM group was significantly longer than that in the HHD and control groups. (Conclusion) These results suggest that enhanced peak torsion in HCM might compensate for untwisting behavior, but this mechanism fails to fully compensate for untwisting behavior compared with HHD. Left ventricular twisting behavior

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P4134Impaired left ventricular systolic function in alcohol abusers expressed by both 3D calculated ejection fraction and longitudinal strain by AFI

European Heart Journal ◽

10.1093/eurheartj/ehz745.0706 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

P Hamala ◽

J D Kasprzak ◽

P Lipiec ◽

K Wierzbowska-Drabik

Keyword(s):

Alcohol Abuse ◽

Ejection Fraction ◽

Longitudinal Strain ◽

Systolic Function ◽

Global Longitudinal Strain ◽

Harmful Effect ◽

Left Ventricular ◽

Control Group ◽

Lv Function ◽

Alcohol Abusers

Abstract Aim Despite knowledge regarding the existence of alcohol cardiomyopathy the exact impact of alcohol abuse in consecutive subject is poorly examined. We aimed to evaluate the left ventricle (LV) function in chronic abusers group and compared classical and novel echocardiography parameters in alcohol abusers (ALC) and control group (C). Methods We compared 75 adults (mean age 48±12, 60 male) without other overt heart disease, coronary artery disease excluded, but with alcohol abuse history: average alcohol intake 32 alcohol unit per week (AUW) with control group consisted of 40 subjects without history of excessive drinking, abstinents or drinking ≤8 AUW (mean age 50±4, 16 men). One unit was defined as 10 grams of pure etanol. All patients underwent TTE examination including ejection fraction (EF) calculation with 3D and longitudinal strain assessment by AFI method. Results ALC group showed LV systolic dysfunction expressed as EF 48±14 vs 60±9%, global longitudinal strain (AFI GLS) −15.6±6.6 vs −18.7±3.4; p<0.0001 and p 0.0064, respectively. On the other hand the LV and left atrial diameters as well as diastolic function were similar in both groups, indicating on relatively low advancement of heart remodeling. ALC vs Control group comparison ALC N75 C N40 p value Age 48±12 50±4 ns BMI 24±6 28±6 0.0009 LVd 48±13 47±4 ns LVs 34±15 32±4 ns LA 38±9 38±3 ns EF 48±14 60±9 <0.0001 E/A 1.1±0.6 1.1±0.3 ns E' lateral 10.6±3.9 10.6±2.9 ns AFI 2ch −15.9±6.9 −18.8±4.8 0.0143 AFI 3ch −15.9±6.9 −18.9±3.6 0.0116 AFI 4ch −15.2±7.1 −18.6±3.5 0.0053 AFI GLS −15.6±6.6 −18.7±3.4 0.0064 Conclusions Chronic alcohol abuse revealed harmful effect on LV systolic function which can be assessed quantitatively by both decreased EF and absolute values of myocardial longitudinal strain. This systolic function impairment seems to anticipate the overt remodelling of the heart.

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