Abstract 14106: Assessment of Right Ventricular to Pulmonary Circulation Uncoupling at Peak Exercise in Heart Failure Patients by the Relationship Between Pulmonary Systolic Pressure vs Right Ventricular Longitudinal Strain

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Valeria Donghi ◽  
Francesco Carbone ◽  
Valentina Labate ◽  
Greta Generati ◽  
Marta Pellegrino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Systolic Pressure ◽  
Peak Exercise ◽  
Group A ◽  
Group B ◽  
The Relationship

Background: Speckle tracking analysis is an emerging technique that can be useful to assess abnormalities in cardiac contractility before traditional echo parameters. Purpose: To investigate whether right ventricular (RV) 2D speckle tracking analysis at peak exercise could stratify a heart failure reduced ejection fraction (HFrEF) population in different functional phenotypes, with particular emphasis on RV to pulmonary circulation relationship. Methods: 36 HFrEF patients (mean age 69±12; male 69%; NYHA I-II-III-IV 19-17-25-5 %) underwent a maximal cardiopulmonary exercise testing evaluation (bike, incremental ramp protocol) combined with Echo-Doppler and off-line speckle tracking analysis. Study population was divided in two groups according to median value of 2D right ventricle longitudinal strain at peak exercise (Group A RVLG at peak < -16, 17 patients vs Group B ≥ -16, 19 patients). In all patients we performed traditional echo and 2D longitudinal speckle tracking analysis at rest and peak exercise. Results: Despite similar left ventricle ejection fraction (Group A 36± 9% vs Group B 32±9%, p=ns) and global right ventricle longitudinal strain (RVLG) at rest (Group A -18.6±5.6% vs Group B -14.5±8.2%, p=ns), Group B patients showed a similar exercise performance (Peak VO 2 Group A 31.6±7.4 vs Group B 11.6±3.4 mlO 2 /Kg/min, p=ns) but more impaired ventilation (VE/VCO2 slope Group A 31.6±7.4 vs Group B 37.4±8.8, p<0.05), and a clear RV to PC uncoupling at peak exercise as assessed by the relationship between pulmonary systolic pressure vs RVLG (see figure below). Conclusions: In HFrEF RV speckle tracking analysis at peak exercise seems a useful technique for unmasking RV to PC uncoupling and the unfavorable gas exchange and ventilatory phenotypes.

Abstract 15733: CD34 + Cell Therapy is Associated With Improved Right Ventricular Function in Heart Failure With Preserved Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sabina Frljak ◽  
Gregor Poglajen ◽  
Gregor Zemljic ◽  
Andraz Cerar ◽  
Francois Haddad ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cell Therapy ◽  
Right Ventricular ◽  
Cell Transplantation ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Group A ◽  
Group B ◽  
Rv Function

Introduction: Right ventricular (RV) dysfunction is an important predictor of adverse prognosis in patients with heart failure with preserved ejection fraction (HFpEF). Hypothesis: We sought to investigate the effects of transendocardial CD34 + cell therapy on RV function in HFpEF patients. Methods: We enrolled 30 patients with HFpEF who underwent transendocardial CD34 + cell transplantation. At baseline, all patients received granulocyte-colony stimulating factor; cells were collected by apheresis and immunomagnetic selection and injected transendocardialy in the left ventricle targeting the areas of local diastolic dysfunction. Patients were followed for 6 months and changes in RV function were assessed by tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity of tricuspid annulus (St), and fractional area change (FAC). Impaired RV function was defined as TAPSE<1.8 cm. Results: At baseline, RV function was impaired in 11 (37%, Group A), and preserved in 19 (63%, Group B) of patients. The groups did not differ in age (64±6 years in Group A vs. 61±11 years in Group B, P=0.37), gender (male: 82% vs. 74%, P=0.61), or left ventricular E/e' (17.7±2.3 vs. 17.3±3.4, P=0.74). Patients in Group A had lower LVEF (55.6±5.1% vs. 61.3±6.5% in Group B, P=0.02), and higher NTproBNP levels (1750±1139 pg/ml vs. 1038±658 pg/ml, P=0.05). At 6 months after cell transplantation we found an overall improvement in all parameters of RV function (TAPSE: +0.21±0.37 cm, P=0.01; St: +0.7±2.1 cm/s, P=0.03; FAC: +8.5±1.9%, P=0.02). However, RV function improvement was significant in Group A (TAPSE: +0.43±0.37 cm, P=0.004; St: +1.4±2.3 cm/s; P=0.01; FAC: +9.8±2.0%, P=0.01), but not in Group B (TAPSE: +0.04±0.27 cm, P=0.65; St: +0.4±1.3 cm/s, P=0.32; FAC: +7.1±3.7%, P=0.08). In both groups we found comparable changes in E/e' (-5.1±3.0 in Group A vs. -5.9±3.2 in Group B, P=0.53), LVEF (1.2±5.7% vs. 1.9±6.5%, P=0.45) and NTproBNP (-462±410 pg/ml vs. -390±398 pg/ml, P=0.64) at 6 months after cell transplantation. Conclusions: Transendocardial CD34 + cell therapy appears to be associated with improvement of right ventricular dysfunction in patients with HFpEF.

Abstract 20168: Right Ventricular Global Longitudinal Strain is Correlated With Cardiovascular Magnetic Resonance Ejection Fraction and Provides Prognostic Value in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tetsuari Onishi ◽  
Kosuke Yoshii ◽  
Masato Tsuru ◽  
Akira Shimane ◽  
Katsunori Okajima ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Arrhythmogenic Right Ventricular Cardiomyopathy ◽  
Global Longitudinal Strain ◽  
Ventricular Cardiomyopathy ◽  
Cardiac Events ◽  
Group A ◽  
Group B

Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by functional abnormalities of the right ventricular (RV). RV ejection fraction (EF) determined by cardiac magnetic resonance (CMR) imaging is accepted as gold standard measure of RV systolic function. Hypothesis: RV global longitudinal strain (GLS) by 2-dimensional speckle tracking echocardiography (2DSTE) is correlated with CMR-RVEF, and associated with cardiac events in patients with ARVC. Methods: We studied 50 patients referred with suspected ARVC. Of them, 19 patients (Group A) were diagnosed as ARVC, while remaining 31 patients (Group B) were not diagnosed due to not meeting criteria. All patients underwent CMR for measurements of RVEF, and echocardiography with conventional assessment including tricuspid annular plane systolic excursion (TAPSE), RV end-diastolic and end-systolic area (RVEDA, RVESA) and RV fractional area change (RVFAC), and with 2DSTE analyses of GLS which was expressed as the absolute value. The cardiac events, defined as death, hospitalization for heart failure, fatal arrhythmia and appropriate defibrillator shock, were followed up for patients in Group A. Results: Patients in Group A had significantly smaller values of TAPSE, RVFAC, GLS and RVEF and significantly greater values of RVESV compared with patients in Group B (p<0.05 for all), while there were no significant differences in RVEDV between 2 groups. GLS were correlated with RVEF (P=0.001, r=0.4) as with RVEDA, RVESA, RVFAC and TAPSE (p<0.01 for all). 4 appropriate defibrillator shocks were observed during averaged 724 days followed-up period in Group A. Dividing patients in Group A into 2 groups with median value of CMR-RVEF or GLS, Kaplan-Meier curve analysis revealed that GLS was significantly associated with outcome (P=0.02), while CMR-RVEF was not. Conclusions: GLS in the RV was significantly correlated with CMR-RVEF, and was associated with cardiac events in patients with ARVC.

P1289 Echocardiograhic prediction of pulmonary arterial capacitance in patients with heart failure with preserved ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Fontes Oliveira ◽  
M Trepa ◽  
R Costa ◽  
A Dias Frias ◽  
S Cabral ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Transthoracic Echocardiography ◽  
Global Longitudinal Strain ◽  
Tertiary Care ◽  
Systolic Pressure ◽  
Preserved Ejection Fraction ◽  
Pulmonary Arterial

Abstract Background Pulmonary arterial capacitance (PAC) has emerged as one of the strongest hemodynamic predictors of adverse outcomes in a wide spectrum of cardiovascular diseases, including pulmonary hypertension in heart failure with preserved ejection fraction (HFpEF-PH). We aimed to study non-invasive surrogates for PAC using transthoracic echocardiography in this population. Methods We retrospectively evaluated consecutive patients referred to an expert tertiary care referral centre from December 2016 to November 2018. Transthoracic echocardiography (TTE) was performed within 1 year of right heart catheterization (RHC). Echo-Pac software from GE Healthcare® was used to perform echocardiographic analysis. PAC was calculated dividing right ventricular stroke volume by pulmonary arterial pulse (systolic – diastolic) pressure, measured by RHC. Results Of the 105 enrolled patients, 43 were had HFpEF-PH. Among these, 72% were female and mean age was 68.9 ± 11.2 years. Median time between TTE and RHC was 68 (IQR 34 – 191) days. Most patients were in NYHA class II (60.5%) and class III (34.9%). Fifty eight percent of the patients had history of paroxysmal or permanent atrial fibrillation. This population presented borderline parameters of right ventricle (RV) systolic dysfunction: fractional area change (FAC) 35.3 ± 9.2%, tricuspid annular plane systolic excursion (TAPSE) 18.3 ± 5.1 mm, tricuspid S’ wave 10.4 ± 2.9 and RV global longitudinal strain -15.5 ± 4.0. Regarding invasive assessment, this population presented mean pulmonary artery pressures of 38.8 ± 13.9 mmHg, pulmonary artery wedge pressure of 21.6 ± 6.4 mmHg, pulmonary vascular resistance of 3.9 ± 2.7 Wood and median PAC of 0.13 (IQR 0.09 – 0.19) ml/mmHg. The TAPSE / Pulmonary arterial systolic pressure (PASP) ratio and the Right ventricular outflow track velocity time integral (RVOT VTI) / PASP ratio were the parameters that best correlated with PAC (r = 0.69, p = 0.002 for both parameters) (table 1). These parameters were obtainable in the majority of patients (31/43). Blant-Altman analysis revealed good agreement between these measures and PAC with a mean difference of - 0.17 (CI -0.21 - -0.13) for RVOT VTI / PASP ratio and -0.23 (CI -0.28 - -0.18) for TAPSE /PASP ratio. Conclusion In a HFpEF – PH population, TAPSE / PASP and RVOT VTI / PASP are easily obtainable in most patients and significantly correlate with PAC. Abstract P1289 Figure.

3D right ventricular ejection fraction and longitudinal strain are independent predictors of major adverse cardiovascular events in patients with rrhythmogenic right ventricular cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Hosseini ◽  
A Sadeghpour ◽  
M Maleki ◽  
A Alizadehasl ◽  
N Rezaeian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Cardiovascular Events ◽  
Longitudinal Strain ◽  
P Value ◽  
Free Wall ◽  
Ventricular Cardiomyopathy ◽  
Rv Function

Abstract Introduction Evaluation of right ventricular (RV) function is essential in the follow up of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Role of advance echocardiography including 3D transthoracic echocardiography (3DTTE) for evaluation of 3D RV function and RV longitudinal strain in predicting prognosis in ARVC patients, has not been well investigated. Purpose We aimed to evaluate 3DTTE parameters in predicting major advance cardiovascular events (MACE) defined as ventricular arrhythmia, cardiac hospitalization, heart transplantation, and death in ARVC patients. Methods Forty-eight definite ARVC subjects based on the 2010 Task force criteria were evaluated with standard 2D transthoracic echocardiography (2DTTE) and 3DTTE. Patients with poor image quality were excluded. RV function was evaluated by 2D and 3D TTE including: fractional area change (FAC), RV global and free wall longitudinal strain (RV2DGLS and RV2DFWLS) and 3D RV ejection fraction (RV3DEF), RV global and free wall longitudinal strain (RV3DGLS, and RV3DFWLS). The patients were followed up for a median period of 12 months (6–18 months) to record MACE. Results Forty-eight patients with mean age =38.5±14 years; 79.2% male, and mean RV3DEF =30.33%, were included. During the mean follow up 12 months, 12 patients (25%, with mean RV3DEF = 24.8±9%) experienced MACE whereas mean RV3EF in patient without any cardiovascular events during follow up was 34.21±9%. The most common causes of hospitalization were arrhythmia, right-sided heart failure, and RV clot as the following: Ventricular arrhythmia in 7 patients (14.6%, with mean RV3DEF = 29.01±8.82%), RV clot in 2 cases (4.2%, with mean RV3DEF = 20.2%), right-sided heart failure in 3 patients (6.3%, with mean RV3DEF = 16.83±3.6%) that 2 of them (2.1%, with mean RV3DEF = 14.58±0.63) underwent heart transplantation. Logistic regression analysis revealed RV3DTTE (p-value = 0.03, OR=0.90, CI: 0.82–0.99), RV3DGLS (p-value = 0.05, OR=1.27, CI: 0.99–1.61) and RV3DFWLS (p-value = 0.01, OR=1.29, CI: 1.05–1.59), predicted cardiac adverse events, but there were no significant association between RV2DGLS, RV2DEWLS and FAC with MACE. Conclusion RV3DEF, RV3DGLS, and RV3DFWLS were powerful predictors of morbidity and mortality and can be useful as a valuable method in the prediction of major cardiovascular complications in ARVC patients. Funding Acknowledgement Type of funding source: None

scholarly journals Tofogliflozin improved pulmonary hypertension due to heart failure with preserved ejection fraction in mice

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y J Joki ◽  
H K Konishi ◽  
K T Takasu ◽  
T M Minamino
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Heart Diseases ◽  
Sglt2 Inhibitor ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Chow Diet ◽  
Normal Chow

Abstract Introduction Pulmonary hypertension (PH) caused by left heart diseases is categorized as the group 2 (PH-LHD). PH-LHD due to heart failure with preserved LV ejection fraction (HFpEF) is more prevalent in patients with metabolic syndrome and shows poorer prognosis than LHD without PH. Tofogliflozin (TOFO) is an SGLT2 inhibitor utilized for diabetic treatment. Recent studies revealed that the SGLT2 inhibitor has a beneficial effect on heart failure; however, it remains unclear whether the SGLT2 inhibitor is effective for the treatment of PH-LHD. Hypothesis We hypothesized that TOFO has a protective effect on PH with HFpEF. Methods We generated two murine models for PH-LHD due to HFpEF, a transverse aortic constriction (TAC) model and a high fat diet (HFD) model. C57BL/6J mice were subjected to TAC and treated with TOFO (3 mg/kg) for 4weeks. In another model, AKR/J mice were fed HFD or normal chow diet and treated with TOFO (3mg/kg in water) for 20 weeks. We then measured physical data including body weight (BW), left ventricular weight (LV), right ventricular weight (RV), and right ventricular systolic pressure (RVSP) and performed echocardiography. Results Mice treated with TOFO demonstrated increased urine glucose level. TAC induced left ventricular hypertrophy and increased RVSP. TOFO treatment improved RV/LV ratio and RVSP in TAC mice (Figure 1). HFD fed AKR/J mice demonstrated increased BW and PH as demonstrated by increased RV/LV ratio and RVSP compared with the normal chow group. TOFO treatment ameliorated the increases of BW, RV/LV ratio, and RVSP in HFD fed AKR/J mice (Figure 2). Conclusions TOFO treatment improved pulmonary hypertension in two models for PH-LHD due to HFpEF, suggesting that the SGLT2 inhibitor is effective for the treatment of this condition. FUNDunding Acknowledgement Type of funding sources: None. Figure 2. TOFO reduced RVSP caused by HFD

Abstract 18506: Right Ventricular and Pulmonary Vascular Reserve in Heart Failure With Preserved Ejection Fraction: An Exercise Cardiac Magnetic Resonance Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Thibault Petit ◽  
Guido Claessen ◽  
Andre La Gerche ◽  
Maarten Vanhaverbeke ◽  
Sander Trenson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Systolic Pressure ◽  
Volume Ratio ◽  
Pulmonary Vasculature ◽  
Control Group ◽  
Contractile Reserve ◽  
Maximal Power Output ◽  
Asymptomatic Subjects

Introduction: Right ventricular dysfunction (RVD) is a marker of adverse outcome in HFpEF patients. While RVD in HFpEF has been demonstrated using dobutamine stress and invasive hemodynamic studies, detailed assessment of RV and pulmonary vascular (PV) function using simultaneous exercise cardiac MRI and invasive hemodynamic measurements has never been performed. Methods In a prospective study, we performed CPET to determine maximal power output (Pmax) in patients with HFpEF (n=11, age 73±9 years) and in healthy controls (n=8, age 53±7 years). We also investigated asymptomatic subjects with echocardiographic evidence of LV concentric remodeling (LVCR) and impaired relaxation (n=4, age 63±7 years). All participants then performed a three-stage supine bicycle exercise test during real-time CMR imaging (at 25%, 50% and 66% of Pmax) with continuous recording of pulmonary arterial pressures using fluid-filled catheters. We determined the ratio of mPAP relative to cardiac output (mPAP/CO slope) as a measure of PV reserve and the change in RV end-systolic pressure volume ratio (dRVESPR) as a measure for RV contractile reserve. Results At rest, there was no difference in LV or RV ejection fraction (EF) between HFpEF patients and controls (p=NS). However, during exercise, HFpEF patients showed a decline in RVEF (-3.9±1.7%), contrasting with a marked increase in RVEF in the control group (+12.49±2.33%, p<0.001 for interaction workload*group, figure 1A). HFpEF patients had a greater mPAP/CO slope (p<0.001, figure 1B) and a significantly lower dRVESPVR (p<0.001) than controls. Interestingly, asymptomatic subjects with LVCR showed an intermediate response to exercise (figure 1A-B). Conclusion In patients with HFpEF, RV functional reserve and pulmonary pressure-flow relationships are markedly impaired. These data suggest an important role for cardiac exercise MRI in phenotyping heart failure patients and guiding RV or pulmonary vasculature targeted therapy.

Abstract 16307: Tofogliflozin Improves Pulmonary Hypertension With Heart Failure With Preserved Ejection Fraction Mice

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yusuke Joki ◽  
Hakuoh Konishi ◽  
Kiyoshi Takasu ◽  
Tohru Minamino
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Beneficial Effect ◽  
Right Ventricular ◽  
Sglt2 Inhibitor ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Sglt2 Inhibitors ◽  
Urine Glucose

Introduction: Pulmonary hypertension (PH) is a syndrome of increased pulmonary artery pressure and often leads to death. Left heart diseases(LHD) are frequently complicated by PH (PH-LHD), classified group2. In particular, PH with heart failure with preserved LV ejection fraction (HFpEF) is higher prevalence metabolic syndrome and poor prognosis than LHD without PH. Tofogliflozin (TOFO) is SGLT2 inhibitor as a therapeutic agent for diabetes. Recent study revealed SGLT2 inhibitors have a beneficial effect on heart failure. However it has not been clarified that SGLT2 inhibitors affect PH-LHD. This study examined whether TOFO improved for PH-LHD. Hypothesis: We hypothesis TOFO has a protective effect for PH with HFpEF. Methods: We used two HFpEF mice models, induced by transverse aortic constriction (TAC) surgery and high fat diet (HFD). TAC model: C57BL/6J mice were subjected to TAC. Sham and TAC mice were treated with TOFO 3mg/kg in water by day or only water. After 4weeks, each mouse was measured physical data, Body weight (BW), Left ventricular weight (LV), Right ventricular weight (RV), right ventricular systolic pressure (RVSP), UCG, collected blood and urine glucose. HFD model: AKR/J mice fed a HFD for 20weeks. Regular diet and HFD mice were treated with TOHO 3mg/kg in water by day or only water. 20weeks later each mouse measured above data. Results and Conclusions: Mice treated with TOFO had significantly higher urine glucose concentrations. TAC induced left ventricular hypertrophy, increased HW/BW ratio and RVSP. However TAC+TOFO mice were reduced hypertrophy and LV/BW ratio than TAC group. Moreover TAC+TOFO mice were improved RV/LV ratio and RVSP (Figure). AKR/J+HFD groups substantially higher BW and occurred PH than RFD groups. In contrast with HFD, TOFO treated group ameliorated BW, RW/LW ratio, moreover normal RVSP. These results showed Tofogliflozin had a beneficial effect for PH with HFpEF.

scholarly journals Additional Prognostic Value of 2D Right Ventricular Speckle-Tracking Strain for Prediction of Survival in Heart Failure and Reduced Ejection Fraction

2019 ◽  
Vol 12 (12) ◽  
pp. 2373-2385 ◽  
Author(s):  
Laura Houard ◽  
Marie-Bénédicte Benaets ◽  
Christophe de Meester de Ravenstein ◽  
Michel F. Rousseau ◽  
Sylvie A. Ahn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Prognostic Value ◽  
Reduced Ejection Fraction ◽  
Prediction Of Survival

P2614Comparison of global longitudinal strain and ejection fraction in correlation to NT-proBNP in ischemic and non-ischemic heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Ablasser ◽  
D Von Lewinski ◽  
E Kolesnik ◽  
M Gangl ◽  
L Kattnig ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection

Abstract Background In chronic heart failure (CHF) NT-proBNP and left ventricular ejection fraction (LVEF) by echocardiography are standard diagnostic as well as follow-up markers and are known to correlate with prognosis. Speckle-tracking echocardiography is a more recent technique to quantify myocardial deformation as a measurement of left ventricular function with potential benefits over LVEF. Purpose The purpose of this investigation was to analyse the cross-sectional relationship between 2D speckle tracking-derived global longitudinal strain (GLS) and NT-proBNP plasma levels in a prospective cohort of ischemic and non-ischemic CHF patients. Methods We enrolled 205 patients with chronic heart failure. Major inclusion criteria were age over 18 years, stable disease with absence of unplanned hospitalization or change in medication or device therapy in the previous month or major surgery in the previous 3 months. CHF treatment had to be according to the recommendations of the ESC CHF guidelines 2016 and LVEF had to be below 50%. Patient history, physical examination and an extensive echocardiography exam were performed. Lab results included NT-proBNP. Manual longitudinal strain was calculated using EchoPAC (General Electric Medical Systems, Horten, Norway) by a single and blinded examiner. LVEF was measured using Simpson's biplane method. Results 205 patients included in the study. The baseline characteristics included mean age 65.0 years and 75% male. Mean GLS was −9.6% (SD ±4.5%) and median NT-proBNP 1269.5 (IQR 379.5–2759.5) ng/ml. The CHF aetiology was 70.0% ischemic vs 30.0% non-ischemic. There was a significant negative correlation between GLS and NT-proBNP (Pearson r=0.239, p=0.029), this was not significant for LVEF and NT-proBNP (Pearson r=0.149, p=0.228).In a multivariate regression analysis adjusted for age, sex, NYHA classification and HF aetiology, GLS remained significantly correlated with NT-proBNP (adjusted beta-coefficient= 0.289, p=0.011). Furthermore, in contrast to LVEF, GLS showed a significant correlation to NT-proBNP in patients with ischemic (Pearson r=0.266, p=0.049) as well as non-ischemic aetiology of heart failure (Pearson r=0.434, p=0.034). Conclusion Global longitudinal strain, not LVEF, was significantly correlated with NT-proBNP in patients with CHF, independently of age, sex, symptoms or heart failure aetiology. This shows that speckle-tracking might be superior to LVEF for the assessment of left ventricular function in CHF.

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