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Myocardial systolic and diastolic performance derived by 2-dimensional speckle tracking echocardiography in heart failure with normal left ventricular ejection fraction.
Circ Heart Fail 2012; 5(5):610-20CH

Abstract

BACKGROUND

The aim of this study was to investigate the myocardial systolic and diastolic performance of the left ventricle (LV) in patients with heart failure with normal LV ejection fraction (HFNEF) through novel LV myocardial indices, which assess the systolic and diastolic function of the whole myocardium of the LV.

METHODS AND RESULTS

LV myocardial systolic and diastolic performance were assessed as the average value of peak systolic strain and peak early-diastolic strain rate, respectively, in longitudinal, circumferential, and radial directions from all LV segments using 2-dimensional speckle-tracking echocardiography. We studied patients with HFNEF and a control group consisting of asymptomatic subjects with LV diastolic dysfunction of similar age, sex, and LV ejection fraction. A total of 322 patients were included (92 with HFNEF and 230 with asymptomatic LV diastolic dysfunction). Myocardial systolic and diastolic LV performance were significantly lower in HFNEF (20.13±6.02% and 1.14±0.27 s(-1)) than in patients with asymptomatic LV diastolic dysfunction (25.33±6.06% and 1.37±0.33 s(-1), respectively; all P<0.0001). In addition, patients with HFNEF with low systolic and diastolic LV myocardial performance had significantly higher LV filling pressures (17.1±6.6 and 17.6±6.3 versus 12.0±5.1 and 11.7±4.7, respectively; all P<0.001) and lower cardiac output (4.8±1.0 L/min and 4.9±1.1 L/min versus 5.7±1.2 L/min and 5.8±1.1 L/min, respectively; all P<0.001) than patients with normal LV myocardial performance. In relation to these findings, the symptomatic status (ie, New York Heart Association functional class) was significantly altered in those patients with low systolic and diastolic LV myocardial performance.

CONCLUSIONS

In patients with HFNEF, both systolic and diastolic LV myocardial performance are impaired, which is associated with increased LV filling pressures, decreased cardiac output, and worse New York Heart Association functional class. Therefore, the measurement of these myocardial parameters could be of great importance in HFNEF because these echocardiographic indices assess the multidirectional function of the whole myocardium of the LV, thereby allowing detection of an alteration of the global function of the LV which is associated with a worse symptomatic status in these patients.

Authors+Show Affiliations

Department of Cardiology (Campus Virchow-Klinikum) of the Charité University Hospital, Augustenburger Platz 1, Berlin, Germany. danielmorris19@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22874137

Citation

Morris, Daniel A., et al. "Myocardial Systolic and Diastolic Performance Derived By 2-dimensional Speckle Tracking Echocardiography in Heart Failure With Normal Left Ventricular Ejection Fraction." Circulation. Heart Failure, vol. 5, no. 5, 2012, pp. 610-20.
Morris DA, Boldt LH, Eichstädt H, et al. Myocardial systolic and diastolic performance derived by 2-dimensional speckle tracking echocardiography in heart failure with normal left ventricular ejection fraction. Circ Heart Fail. 2012;5(5):610-20.
Morris, D. A., Boldt, L. H., Eichstädt, H., Ozcelik, C., & Haverkamp, W. (2012). Myocardial systolic and diastolic performance derived by 2-dimensional speckle tracking echocardiography in heart failure with normal left ventricular ejection fraction. Circulation. Heart Failure, 5(5), pp. 610-20.
Morris DA, et al. Myocardial Systolic and Diastolic Performance Derived By 2-dimensional Speckle Tracking Echocardiography in Heart Failure With Normal Left Ventricular Ejection Fraction. Circ Heart Fail. 2012 Sep 1;5(5):610-20. PubMed PMID: 22874137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myocardial systolic and diastolic performance derived by 2-dimensional speckle tracking echocardiography in heart failure with normal left ventricular ejection fraction. AU - Morris,Daniel A, AU - Boldt,Leif-Hendrik, AU - Eichstädt,Hermann, AU - Ozcelik,Cemil, AU - Haverkamp,Wilhelm, Y1 - 2012/08/08/ PY - 2012/8/10/entrez PY - 2012/8/10/pubmed PY - 2012/12/10/medline SP - 610 EP - 20 JF - Circulation. Heart failure JO - Circ Heart Fail VL - 5 IS - 5 N2 - BACKGROUND: The aim of this study was to investigate the myocardial systolic and diastolic performance of the left ventricle (LV) in patients with heart failure with normal LV ejection fraction (HFNEF) through novel LV myocardial indices, which assess the systolic and diastolic function of the whole myocardium of the LV. METHODS AND RESULTS: LV myocardial systolic and diastolic performance were assessed as the average value of peak systolic strain and peak early-diastolic strain rate, respectively, in longitudinal, circumferential, and radial directions from all LV segments using 2-dimensional speckle-tracking echocardiography. We studied patients with HFNEF and a control group consisting of asymptomatic subjects with LV diastolic dysfunction of similar age, sex, and LV ejection fraction. A total of 322 patients were included (92 with HFNEF and 230 with asymptomatic LV diastolic dysfunction). Myocardial systolic and diastolic LV performance were significantly lower in HFNEF (20.13±6.02% and 1.14±0.27 s(-1)) than in patients with asymptomatic LV diastolic dysfunction (25.33±6.06% and 1.37±0.33 s(-1), respectively; all P<0.0001). In addition, patients with HFNEF with low systolic and diastolic LV myocardial performance had significantly higher LV filling pressures (17.1±6.6 and 17.6±6.3 versus 12.0±5.1 and 11.7±4.7, respectively; all P<0.001) and lower cardiac output (4.8±1.0 L/min and 4.9±1.1 L/min versus 5.7±1.2 L/min and 5.8±1.1 L/min, respectively; all P<0.001) than patients with normal LV myocardial performance. In relation to these findings, the symptomatic status (ie, New York Heart Association functional class) was significantly altered in those patients with low systolic and diastolic LV myocardial performance. CONCLUSIONS: In patients with HFNEF, both systolic and diastolic LV myocardial performance are impaired, which is associated with increased LV filling pressures, decreased cardiac output, and worse New York Heart Association functional class. Therefore, the measurement of these myocardial parameters could be of great importance in HFNEF because these echocardiographic indices assess the multidirectional function of the whole myocardium of the LV, thereby allowing detection of an alteration of the global function of the LV which is associated with a worse symptomatic status in these patients. SN - 1941-3297 UR - https://www.unboundmedicine.com/medline/citation/22874137/Myocardial_systolic_and_diastolic_performance_derived_by_2_dimensional_speckle_tracking_echocardiography_in_heart_failure_with_normal_left_ventricular_ejection_fraction_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.112.966564?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -