scholarly journals Correction: Prognostic value of left ventricular mitral annular longitudinal displacement obtained by tissue doppler imaging in patients with heart failure with reduced ejection fraction

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001494corr1
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Tissue Doppler Imaging ◽  
Prognostic Value ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Longitudinal Displacement ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

scholarly journals Prognostic value of left ventricular mitral annular longitudinal displacement obtained by tissue Doppler imaging in patients with heart failure with reduced ejection fraction

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001494
Author(s):  
Morten Sengeløv ◽  
Peter Godsk ◽  
Niels Eske Bruun ◽  
Flemming Javier Olsen ◽  
Thomas Fritz-Hansen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Independent Predictor ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Longitudinal Displacement ◽  
Significant Independent Predictor ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

BackgroundTissue Doppler imaging (TDI) can be used to measure the mitral annular longitudinal displacement (LD) during systole. However, the prognostic utility of global and regional LD in patients with heart failure with reduced ejection fraction (HFrEF) is unknown.MethodsEchocardiographic examinations from 907 patients with HFrEF were analysed obtaining conventional echocardiographic measurements. Regional LD was obtained from colour TDI projections in six mitral annular regions and global LD was calculated as an average.ResultsMean age was 67 years, 26.9% were women and mean left ventricular ejection fraction was 27%. During a median follow-up period of 40 months, 150 (16.5 %) patients died. The risk of dying increased with decreasing tertile of global LD and was approximately five times higher for patients in the lowest tertile compared with the highest (1. tertile vs 3. tertile, HR 4.9, 95% CI: 3.0 to 7.9, p<0.001).Global LD was a significant independent predictor of mortality after adjusting for age, gender, body mass index, pacemaker, heart rate, atrial fibrillation, diabetes and conventional echocardiographic measures and global longitudinal strain: HR 1.16 (95% CI: 1.00 to 1.34, p=0.044) per 1 mm decrease.For regional measures, inferior LD was also a significant independent predictor in the multivariable model: HR 1.16 (95% CI: 1.04 to 1.29, p=0.006) and adding inferior LD to the conventional measures yielded a significant increase in Harrell’s C-statistic (95% CI: 0.75 to 0.78, p=0.009).ConclusionIn patients with HFrEF, global and inferior LD are independent predictors of all-cause mortality. Furthermore, inferior LD proved to be a significant prognosticator when compared with all the conventional echocardiographic parameters.

Prognostic value of global longitudinal layer specific strain for patients with heart failure with reduced ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Johnsen ◽  
M Sengeloev ◽  
P Joergensen ◽  
N Bruun ◽  
D Modin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Volume Index ◽  
Funding Source ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Abstract Background Novel echocardiographic software allows for layer-specific evaluation of myocardial deformation by 2-dimensional speckle tracking echocardiography. Endocardial, epicardial- and whole wall global longitudinal strain (GLS) may be superior to conventional echocardiographic parameters in predicting all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF). Purpose The purpose of this study was to investigate the prognostic value of endocardial-, epicardial- and whole wall GLS in patients with HFrEF in relation to all-cause mortality. Methods We included and analyzed transthoracic echocardiographic examinations from 1,015 patients with HFrEF. The echocardiographic images were analyzed, and conventional and novel echocardiographic parameters were obtained. A p value in a 2-sided test &lt;0.05 was considered statistically significant. Cox proportional hazards regression models were constructed, and both univariable and multivariable hazard ratios (HRs) were calculated. Results During a median follow-up time of 40 months, 171 patients (16.8%) died. A lower endocardial (HR 1.17; 95% CI (1.11–1.23), per 1% decrease, p&lt;0.001), epicardial (HR 1.20; 95% CI (1.13–1.27), per 1% decrease, p&lt;0.001), and whole wall (HR 1.20; 95% CI (1.14–1.27), per 1% decrease, p&lt;0.001) GLS were all associated with higher risk of death (Figure 1). Both endocardial (HR 1.12; 95% CI (1.01–1.23), p=0.027), epicardial (HR 1.13; 95% CI (1.01–1.26), p=0.040) and whole wall (HR 1.13; 95% CI (1.01–1.27), p=0.030) GLS remained independent predictors of mortality in the multivariable models after adjusting for significant clinical parameters (age, sex, total cholesterol, mean arterial pressure, heart rate, ischemic cardiomyopathy, percutaneous transluminal coronary angioplasty and diabetes) and conventional echocardiographic parameters (left ventricular (LV) ejection fraction, LV mass index, left atrial volume index, deceleration time, E/e', E-velocity, E/A ratio and tricuspid annular plane systolic excursion). No other echocardiographic parameters remained an independent predictors after adjusting. Furthermore, endocardial, epicardial and whole wall GLS had the highest C-statistics of all the echocardiographic parameters. Conclusion Endocardial, epicardial and whole wall GLS are independent predictors of all-cause mortality in patients with HFrEF. Furthermore, endocardial, epicardial and whole wall GLS were superior prognosticators of all-cause mortality compared with all other echocardiographic parameters. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Herlev and Gentofte Hospital

Abstract 15943: Left Ventricular Regional Longitudinal Displacement Assessed by Tissue Doppler Imaging is a Powerful Predictor of All-cause Mortality in Patients With Systolic Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Morten Sengeløv ◽  
Peter Godsk Jørgensen ◽  
Niels Eske Bruun ◽  
Flemming Javier Olsen ◽  
Thomas Fritz Hansen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tissue Doppler Imaging ◽  
Systolic Heart Failure ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Longitudinal Displacement ◽  
Predictors Of Mortality ◽  
All Cause Mortality ◽  
Echocardiographic Parameters

Objective: Tissue tracking (TT), obtained by tissue Doppler imaging (TDI), can be utilized to assess the mitral annular longitudinal displacement (LD) during systole. However, the prognostic utility of regional LD in patients with heart failure with reduced ejection fraction (HFrEF) is unknown. Methods: Transthoracic echocardiographic examinations from 911 patients with HFrEF were retrieved from a heart failure clinic’s database. The exams were performed from 2005 to 2013. The echocardiographic images were subsequently analyzed obtaining conventional echocardiographic measurements. Regional LD was obtained from the three apical TDI projections with sampling at six mitral annular sites located at the anterior, lateral, posterior, inferior, septal and anteroseptal myocardial walls. Results: During a median follow-up period of 40 months 150 (16.4 %) patients died. Patients that died had significantly lower LVEF (23.3% vs 28.3%, p<0.001) and lower regional LD in all six mitral annular sites (Figure). Many conventional echocardiographic parameters presented as predictors of mortality (LVEF, LVMI, LAVI, E, E/e’, deceleration time and TAPSE). However, only LD at the septal and inferior annular sites remained independent predictors of mortality in cox proportional-hazards models after adjusting for age, gender, BMI, total cholesterol, heart rate, atrial fibrillation, non-independent diabetes mellitus and the aforementioned conventional echocardiographic predictors (Figure). In addition, the septal and the inferior sites had the highest Harrell’s C-statistic of all the echocardiographic predictors (0.70 and 72, respectively). Conclusion: In patients with severe heart failure, septal and inferior LD are independent predictors of all-cause mortality. Furthermore, septal and inferior LD proved to be superior prognosticators when compared to all the conventional echocardiographic parameters.

scholarly journals Prognostic of NT-proBNP in heart failure patients with preserved, mid and reduced ejection fraction

2021 ◽  
Vol 5 (3) ◽  
pp. 5-12
Author(s):  
Reynie Leonel Reinoso Gonella ◽  
Yasmín Céspedes Batista ◽  
Anthony Gutiérrez ◽  
Lisnaldy Ramírez Osoria ◽  
Helio Manuel Grullón Rodríguez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mortality Rate ◽  
Ejection Fraction ◽  
Plasma Levels ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

Objective. The prognostic value of N-terminal procerebral natriuretic peptide (NT-proBNP) in patients with heart failure (HF) is well established. In contrast, its role as an early predictor of mortality in patients hospitalized for heart failure with preserved ejection fraction (HF-EF) and heart failure with reduced ejection fraction (HF-EF) is less well documented. Therefore, the objective of this study is to evaluate the usefulness and prognostic value of plasma NT-proBNP in these patients. Method. This retrospective observational study included 620 patients admitted for acute heart failure, classified into 3 groups according to their left ventricular ejection fraction (LVEF): HF-EF (LVEF ≥ 50%), HF-mEF (heart failure with ejection fraction mean) (LVEF 35-49%) and HF-rEF (LVEF <40%), whose plasma levels of NT-proBNP and clinical data were determined at hospital admission. Univariate and multivariate logistic regression was used to perform prognostic values of NT-proBNP levels for 3.4 years of all-cause mortality in each group. Results: The mean plasma levels of NT-proBNP in patients with HF-cEF (35%) and borderline HF-cEF (43%) was 1001-5000 pg / ml; patients with HF-rEF were similarly distributed between the groups 1001-5000pg / ml (30%), 5001-15000pg / ml (31%) and> 15001pg / ml (30.6%). The mortality rate increased significantly in patients with NT-proBNP concentrations > 15001 pg / ml (40%) and decreased with NT-proBNP levels <250 pg / ml (4%), compared to the other NT-proBNP groups. The mortality rate increased proportionally to elevated baseline NT-proBNP, regardless of LVEF. Conclusion. In patients hospitalized for an acute decompensated event with HF-cEF (LVEF ≥50%) and HF-mEF (LVEF 35-49%), plasma levels of NT-proBNP are a useful tool to predict early mortality, as for HF -FEr (LVEF <40%).

scholarly journals Torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking sacubitril/valsartan and naive

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
WED El Shafey ◽  
EHAB Elmelegy ◽  
WALAA Mousa ◽  
MENA Shafek
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Tissue Doppler Imaging ◽  
Speckle Tracking ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Short Term ◽  
Reduced Ejection Fraction ◽  
2D Speckle Tracking

Abstract Funding Acknowledgements Type of funding sources: None. Background ARNI has been shown to be superior to enalapril in long term reducing the mortality and hospitalization of heart failure (HF). However short-term effect on diastolic function remain unclear. We sought to evaluate 6 months" effects of ARNI on left ventricular (LV) diastolic parameters determined by speckle tracking and tissue Doppler imaging. Objectives This study aims to evaluate the torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking angiotensin receptor neprilysin inhibitors (ARNI) and non. Methods This study was carried out in Menoufia university hospitals included 60 patients of HFrEF during the period from august 2019 to January 2020. (50%) of patients was treated with traditional treatment of heart failure and the remaining was treated with ARNI. Data were collected including history and clinical examination. ECG and speckle tracking and tissue Doppler imaging was done to evaluate the diastolic function. Results Our results showed no significant difference between the two groups at baseline. There was significant improvement of the LV diastolic function. Untwist time and untwist onset showed the highly significant parameters of improvement. Conclusion This study concluded that ARNI showed short term improvement of diastolic function of the left ventricle that can be detected by STE. Comparison between the studied groups re Echocardiographic diastolic parameters after 6 months ARNI Traditional P-value (Sig.) Count 30 30 Diastolic dysfunction grade Grade 1 9 (30%) 1 (3.3%) 0.008 (S) Grade 2 18 (60%) 22 (73.4%) Grade 3 3 (10%) 7 (23.3%) Other doppler diastolic parameters E/A 0.93 ± 0.30 1.16 ± 0.26 0.002 (S) E/e" 9.1 ± 1.9 10.8 ± 1.6 &lt;0.001 (HS) TR velocity (m/s) 2.6 ± 0.3 2.8 ± 0.3 0.003 (S) Speckle diastolic parameters Untwist rate (°/s) -65.4 ± 5.2 -60.4 ± 4.5 &lt;0.001 (HS) Untwist onset (ms) 96.8 ± 16.2 106.1 ± 15.7 0.028 (S) Shows comparison between ARNI vs Traditionally treated patients and how the parameters of conventional and STE was improved in favor of diastolic parameters. Abstract Figure. Baseline vs 6 months inbetween studied g

Abstract 13497: Prognostic Value of the Combination of the Echocardiographic Derived Pulmonary Artery Wedge Pressure and Body Mass Index in Patients With Heart Failure With Preserved Ejection Fraction: Insights From PURSUIT-HFpEF Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kumpei Ueda ◽  
Shungo Hikoso ◽  
Daisaku D Nakatani ◽  
Shunsuke Tamaki ◽  
Masamichi Yano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Mass Index ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Pulmonary Artery Wedge Pressure ◽  
Patients With Heart Failure ◽  
Wedge Pressure

Background: An elevated pulmonary artery wedge pressure (PAWP), a surrogate of left ventricular filling pressure, is associated with poor outcomes in patients with heart failure (HF). In addition, obesity paradox is well recognized in HF patients and body mass index (BMI) also provides a prognostic information. However, there is little information available on the prognostic value of the combination of the echocardiographic derived PAWP and BMI in patients with HF with preserved ejection fraction (HFpEF). Methods and Results: Patients data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, which is a prospective multicenter observational registry for acute decompensated heart failure (ADHF) patients with HFpEF. We analyzed 548 patients after exclusion of patients undergoing hemodialysis, patients with in-hospital death, missing follow-up data, or missing data to calculate PAWP or BMI. Body weight measurement and echocardiography were performed just before discharge. PAWP was calculated using the Nagueh formula [PAWP = 1.24* (E/e’) + 1.9] with e’ = [(e’ septal + e’ lateral ) /2]. During a mean follow up period of 1.5±0.8 years, 86 patients had all-cause death (ACD). Multivariate Cox analysis showed that both PAWP (p=0.020) and BMI (p=0.0001) were significantly associated with ACD, independently of age and previous history of HF hospitalization, after the adjustment with gender, left ventricular ejection fraction, NT-proBNP and estimated glomerular filtration rate. Kaplan-Meier curve analysis revealed that there was a significant difference in the risk of ACD when patients were stratified into 3 groups based on the median values of PAWP (17.3) and BMI (21.4). Conclusions: The combination of the echocardiographic derived PAWP and BMI might be useful for stratifying ADHF patients with HFpEF at risk for the total mortality.

scholarly journals Post-exertional increase in first-phase ejection fraction in recreational marathon runners

2020 ◽  
Vol 9 ◽  
pp. 204800402092636
Author(s):  
Luca Faconti ◽  
Iain Parsons ◽  
Bushra Farukh ◽  
Ryan McNally ◽  
Lorenzo Nesti ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Tissue Doppler Imaging ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Cardiac Performance ◽  
Doppler Imaging ◽  
Marathon Running ◽  
Aortic Blood Flow ◽  
Marathon Runners

Objectives Running a marathon has been equivocally associated with acute changes in cardiac performance. First-phase ejection fraction is a novel integrated echocardiographic measure of left ventricular contractility and systo-diastolic coupling which has never been studied in the context of physical activity. The aim of this study was to assess first-phase ejection fraction following recreational marathon running along with standard echocardiographic indices of systolic and diastolic function. Design and participants: Runners (n = 25, 17 males), age (mean ± standard deviation) 39 ± 9 years, were assessed before and immediately after a marathon race which was completed in 4 h, 10 min ± 47 min. Main outcome measures Central hemodynamics were estimated with applanation tonometry; cardiac performance was assessed using standard M-mode two-dimensional Doppler, tissue-doppler imaging and speckle-tracking echocardiography. First-phase ejection fraction was calculated as the percentage change in left ventricular volume from end-diastole to the time of peak aortic blood flow. Results Conventional indices of systolic function and cardiac performance were similar pre- and post-race while aortic systolic blood pressure decreased by 9 ± 8 mmHg ( P < 0.001) and first-phase ejection fraction increased by approximately 48% from 16.3 ± 3.9% to 22.9 ± 2.5% ( P < 0.001). The ratio of left ventricular transmitral Doppler early velocity (E) to tissue-doppler imaging early annular velocity (e′) increased from 5.1 ± 1.8 to 6.2 ± 1.3 ( P < 0.01). Conclusion In recreational marathon runners, there is a marked increase in first-phase ejection fraction after the race despite no other significant change in cardiac performance or conventional measure of systolic function. More detailed physiological studies are required to elucidate the mechanism of this increase.

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