P3540The predictive value of global longitudinal strain in patients with heart failure mid-range ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Wei-Ting ◽  
C T Liao ◽  
Z C Chen
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Ventricular Ejection Fraction ◽  
Predictive Values

Abstract Background Heart failure with mid-range ejection fraction (HFmrEF) was defined as the typical symptoms of HF with a left ventricular ejection fraction (LVEF) of 41% to 49%. However, till now the progression of LV function and the subsequent prognosis remains largely unknown. Speckle tracking echocardiography (STE) is a novel method to detect the early myocardial dysfunction and has been used to differentiate the outcomes of different phenotypes of cardiovascular diseases. Purpose Herein, we aim to investigate the application of STE in HFmrEF and its predictive values. Methods Retrospectively, we collected the medical records and echocardiography imaging of 250 patients diagnosed as HFmrEF during 2014 to 2018. LV longitudinal strain at diagnosis was evaluated and compared with the changes of LV during the follow-up period. Also, mortality and major adverse cardiovascular events (MACE) including myocardial infarction, heart failure requiring admission were recorded. Results Our result indicated that a reduced LV longitudinal strain at baseline was significantly associated with a subsequent declined LVEF beneath 40%. Also, the lower strain a baseline implied the higher mortality and MACE. Using −12% as the cut-off value LV strain presented the most significant impact on the prognosis compared with the other echocardiographic parameters in the logistic regression Regarding the guideline directed medications, blockers of renin-angiotensin-aldosterone system most significantly improved the cardiac remodeling compared with the others. Conclusion STE can predict the subsequent changes of LVEF and the cardiovascular outcomes in patients with HFmrEF.

scholarly journals P818 Association between baseline left ventricular longitudinal strain and follow-up left ventricular ejection fraction in patients with dilated cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I H Jung ◽  
Y S Byun ◽  
J H Park
Keyword(s):  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Reverse Remodeling ◽  
Lv Function ◽  
Ventricular Ejection Fraction

Abstract Funding Acknowledgements no Background Left ventricular global longitudinal strain (LV GLS) offers sensitive and reproducible measurement of myocardial dysfunction. The authors sought to evaluate whether LV GLS at the time of diagnosis may predict LV reverse remodeling (LVRR) in DCM patients with sinus rhythm and also investigate the relationship between baseline LV GLS and follow-up LVEF. Methods We enrolled patients with DCM who had been initially diagnosed, evaluated, and followed at our institute. Results During the mean follow-up duration of 37.3 ± 21.7 months, LVRR occurred in 28% of patients (n = 45) within 14.7 ± 10.0 months of medical therapy. The initial LV ejection fraction (LVEF) of patients who recovered LV function was 26.1 ± 7.9% and was not different from the value of 27.1 ± 7.4% (p = 0.49) of those who did not recover. There was a moderate and highly significant correlation between baseline LV GLS and follow-up LVEF (r = 0.717; p <0.001). Conclusion There was a significant correlation between baseline LV GLS and follow-up LVEF in this population. Baseline Follow-up Difference (95% CI) p-value All patients (n = 160) LVEDDI, mm/m2 35.6 ± 6.6 35.6 ± 6.6 -2.7 (-3.4 to -2.0) <0.001 LVESDI, mm/m2 30.3 ± 6.1 26.6 ± 6.6 -3.7 (-4.6 to -2.8) <0.001 LVEDVI, mL/m2 95.0 ± 30.7 74.3 ± 30.2 -20.7 (-25.6 to -15.8) <0.001 LVESVI, mL/m2 70.0 ± 24.8 50.2 ± 26.8 -19.8 (-24.2 to -15.4) <0.001 LVEF, % 26.8 ± 7.5 33.9 ± 12.6 7.2 (5.2 to 9.2) <0.001 LV GLS (-%) 9.2 ± 3.1 11.0 ± 4.8 1.8 (1.3 to 2.2) <0.001 Patients without LVRR (n = 115) LVEDDI, mm/m2 34.9 ± 6.8 34.1 ± 6.8 -0.8 (-1.3 to -0.3) 0.002 LVESDI, mm/m2 29.5 ± 6.1 28.4 ± 6.4 -1.4 (-1.8 to -0.4) 0.002 LVEDVI, mL/m2 92.0 ± 30.5 83.4 ± 29.8 -8.6 (-12.4 to -4.8) <0.001 LVESVI, mL/m2 67.1 ± 24.4 59.5 ± 25.3 -7.6 (-10.9 to -4.3) <0.001 LVEF, % 27.1 ± 7.4 27.8 ± 7.4 0.7 (-0.2 to 1.6) 0.126 LV GLS (-%) 8.2 ± 2.9 8.7 ± 3.2 0.5 (0.7 to 3.6) <0.001 Patients with LVRR (n = 45) LVEDDI, mm/m2 37.4 ± 5.5 29.8 ± 5.2 -7.5 (-9.1 to -6.0) <0.001 LVESDI, mm/m2 32.2 ± 5.7 21.9 ± 4.4 -10.3 (-11.9 to -8.6) <0.001 LVEDVI, mL/m2 102.7 ± 30.2 51.1 ± 15.0 -51.7 (-61.6 to -41.7) <0.001 LVESVI, mL/m2 77.3 ± 24.5 26.4 ± 11.3 -50.9 (-58.8 to -43.1) <0.001 LVEF, % 26.1 ± 7.9 49.4 ± 9.5 23.9 (20.4 to 27.5) <0.001 LV GLS (-%) 11.9 ± 1.6 16.9 ± 2.7 5.1 (4.2 to 5.9) <0.001 Baseline and Follow-up LV Functional Echocardiographic Data Abstract P818 Figure.

Abstract 17994: Echocardiographic parameters of Left Ventricular Size and Function as Predictors of Symptomatic Heart Failure in Patients with Low Normal Ejection Fraction Treated with Anthracyclines

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Negareh Mousavi ◽  
Timothy Tan ◽  
Mohammad Ali ◽  
Elkan F. Halpern ◽  
Lin Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Symptomatic Heart Failure ◽  
Echocardiographic Parameters ◽  
And Function

Objectives: The aim of this study was to assess whether baseline echocardiographic measures of left ventricular (LV) size and function predict the development of symptomatic heart failure or cardiac death (major adverse cardiac events, MACE) in patients treated with anthracyclines who have a pre-chemotherapy left ventricular ejection fraction (LVEF) in the low normal range (between 50-59%). Background: Anthracycline-induced symptomatic heart failure and impaired LVEF are late and often irreversible manifestations of anthracycline-induced cardiotoxicity. The value of echocardiographic parameters of myocardial size and function before chemotherapy to identify patients at high-risk for development of symptomatic heart failure in patients with low normal LVEF was studied. Methods: Patients with a LVEF between 50 and 59% before anthracyclines were selected. In these patients, LV volumes, LVEF and peak longitudinal strain (GLS) were measured. Individuals were followed for MACE and all-cause mortality over a median of 659 days (range; 3-3704 days). Results: Of 2234 patients undergoing echocardiography for pre-anthracycline assessment, 158 (7%) had a resting ejection fraction of 50-59%. Their average LV end-diastolic volume (LVEDV) was 101±22ml, LVEF was 54 ±3% and global longitudinal strain (GLS) was -17.7±2.6%. Twelve patients experienced a MACE (congestive heart failure) at a median of 173 days (range; 15-530). Age, diabetes, previous coronary artery disease, LVEDV, LVESV and GLS were all-predictive of MACE (P= 0.015, 0.0043 and 0.0065 for LVEDV, LVESV, and GLS respectively). LVEDV and GLS remained predictive of MACE when adjusted for age. Age and GLS were also predictive of overall mortality (p<0.0001 and 0.0105 respectively). Conclusions: In patients treated with anthracyclines with an LVEF of 50-59%, both baseline EDV and GLS predict the occurrence of MACE. These parameters may help target patients who could bene[[Unable to Display Character: &#64257;]]t from closer cardiac surveillance and earlier initiation of cardioprotective medical therapy.

scholarly journals P1780 Left ventricular golbal longitudinal strain in acute myocardial infarction and incidence of in hospital heart failure

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H Ebeid ◽  
R Abd El Hady ◽  
K El Khashab ◽  
M Husein
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Abstract Background The occurrence of in-hospital heart failure in the acute phase of myocardial infarction carries an ominous prognosis and is often preceded by abrupt loss of functioning myocardium. However ,In hospital heart failure may occur in patients with apparently only minor myocardial injury and preserved or only moderately reduced left ventricular ejection fraction and still carries a significantly increased risk of adverse outcome. In patients with clinical symptoms of heart failure despite preserved left ventricular ejection fraction(heart failure with preserved ejection fraction), abnormalities in longitudinal myocardial mechanics have been reported suggesting that the discrepancy between near normal left ventricular ejection fraction and clinical symptoms may be partially explained by theses indices. Purpose Evaluation of the role of global longitudinal strain in prediction of the occurrence of in hospital heart failure in patients presenting with acute myocardial infarction particularly in patients with normal ,or moderately impaired ejection fraction. Methods forty patients with first attack of acute myocardial infarction were ranked according to killip class during their hospital admission and course. The patients were divided into two groups: Group 1: patients having in-hospital heart failure (killip class &gt; 1).Group2: Patients not having in–hospital heart failure (killip class = 1). Echocardiogaraphic examination was done for them including global longitudinal strain within 72 hours after successful reperfusion .Comparison of different echocardiographic parameters between the two groups was done. Patients with mildly impaired ejection fraction (Ejection fraction &gt; 40%) were studied for echocardiographic parameters correlated significantly with the occurrence of in-hospital heart failure . Results Patients with in-hospital heart failure had significantly impaired global longitudinal strain(-8.63%+1.57% vs -12.41%+1.31%, p = 0.000), lower left ventricular ejection fraction (34.17%+8.17% vs 42.92 %+7.98%,p &lt; 0.001) and higher wall motion score index (1.57 + 0.32 vs 1.31 +0.24 ,p &lt; 0.006). In patients with left ventricular ejection fraction &gt;40% experienced in-hospital heart failure also exhibited significantly impaired global longitudinal strain p= 0.035 . Conclusion Global longitudinal strain can offer accurate, feasible, and non invasive predictor of hemodynamic deterioration in patients with myocardial infarction. Global longitudinal strain was superior to left ventricular ejection fraction , wall motion score index in evaluation of myocardial dysfunction specially in those with preserved left ventricular ejection fraction(EF &gt; 40%).Global longitudinal strain was also superior to left ventricular ejection fraction , wall motion score index in detection of patients with Killip class II ( those without overt heart failure ,and who can be easily missed).

scholarly journals P803 Myocardial work in acutely decompensated heart failure patients differs between HFrEF and HFpEF

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
F Sahiti ◽  
C Morbach ◽  
C Henneges ◽  
M Hanke ◽  
R Ludwig ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Future Research ◽  
Lv Function ◽  
Acutely Decompensated Heart Failure

Abstract OnBehalf AHF Registry Background & Aim A novel echocardiographic method to non-invasively determine left ventricular (LV) myocardial work (MyW) based on speckle-tracking derived longitudinal strain and blood pressure has recently been validated against invasive reference measurements. MyW is considered less load-dependent than LV ejection fraction (EF) and LV longitudinal strain. We investigated MyW indices in patients with reduced ejection fraction (LVEF &lt;40%; HFrEF) and patients with preserved ejection fraction (LVEF ≥50%, HFpEF) admitted for acutely decompensated heart failure (AHF). Methods The AHF registry is a monocentric prospective follow-up study that comprehensively phenotypes consecutive patients hospitalized for AHF. Echocardiography was performed on the day of admission. MyW assessment was performed off-line using EchoPAC (GE, version 202). Here we present MyW indices and performed two-sided t-tests to analyze differences in numerical baseline covariates. Results We analyzed the echocardiograms of 94 AHF patients (72 ± 10 years; 36% female). 46 patients (49%) had an LVEF &lt;40%, while 48 patients (51%) presented with LVEF ≥50%. HFrEF patients were younger, less often female, and hat lower blood pressure (table). Consistent with lower LVEF, HFrEF patients had less negative global longitudinal strain and lower global constructive work, when compared to HFpEF patients. Since HFrEF patients also had higher global wasted work, this yielded a lower myocardial work efficiency compared to HFpEF patients (table). Conclusions This analysis in patients with AHF exhibited marked differences in MyW indices according to subgroups with HFrEF and HFpEF, thus adding information to the classical measures of LV function. Future research has to determine whether constructive and/or wasted MyW are valuable diagnostic or therapeutic targets in patients with AHF. Abstract P803 Figure.

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