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Left ventricular global longitudinal strain is associated with exercise capacity in failing hearts with preserved and reduced ejection fraction.
Eur Heart J Cardiovasc Imaging. 2015 Feb; 16(2):217-24.EH

Abstract

AIMS

Heart failure patients with reduced and preserved left ventricular (LV) ejection fraction (EF) show reduced exercise capacity. We explored the relationship between exercise capacity and systolic and diastolic myocardial function in heart failure patients.

METHODS AND RESULTS

Exercise capacity, by peak oxygen uptake (VO2), was assessed in 100 patients (56 ± 12 years, NYHA functional class: 2.5 ± 0.9, EF: 42 ± 19%). LV systolic function, as EF and global longitudinal strain (GLS), and right ventricular function were assessed by echocardiography. Left atrial volume index and the ratio of peak early diastolic filling velocity (E) to early diastolic mitral annular velocity (e') were measures of diastolic function. Thirty-seven patients had heart failure with preserved EF (HFpEF), defined as EF ≥50% and echocardiographic diastolic dysfunction. LV GLS and peak pulmonary arterial systolic pressure were independently correlated to peak VO2 in the total study population and in HFpEF separately. LV GLS was superior to EF in identifying patients with impaired peak VO2 <20 mL/kg/min as shown by receiver operating characteristic analyses [areas under curves 0.93 (0.89-0.98) vs. 0.85 (0.77-0.93), P < 0.05]. In patients with HFpEF, GLS was reduced below normal (-17.5 ± 3.2%) and correlated to E/e' (R = 0.45, P = 0.005) and left atrial volume index (R = 0.48, P = 0.003), while EF did not.

CONCLUSION

GLS correlated independently to peak VO2 in patients with reduced and preserved EF and was superior in identifying patients with reduced exercise capacity. In HFpEF, systolic function by GLS was impaired. There was a significant relationship between diastolic function and GLS, confirming a coupling between diastolic and longitudinal systolic function in HFpEF.

Authors+Show Affiliations

Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway Center for Cardiological Innovation, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway Institute for Surgical Research, Rikshospitalet, Oslo University Hospital, Oslo, Norway.Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway Center for Cardiological Innovation, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway Institute for Surgical Research, Rikshospitalet, Oslo University Hospital, Oslo, Norway.Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway Center for Cardiological Innovation, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway Institute for Surgical Research, Rikshospitalet, Oslo University Hospital, Oslo, Norway.Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway K.G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, Oslo, Norway.Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway.Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway Center for Cardiological Innovation, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway Institute for Surgical Research, Rikshospitalet, Oslo University Hospital, Oslo, Norway.Department of Cardiology, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, Oslo, Norway Center for Cardiological Innovation, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway Institute for Surgical Research, Rikshospitalet, Oslo University Hospital, Oslo, Norway thor.edvardsen@medisin.uio.no.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25552469

Citation

Hasselberg, Nina E., et al. "Left Ventricular Global Longitudinal Strain Is Associated With Exercise Capacity in Failing Hearts With Preserved and Reduced Ejection Fraction." European Heart Journal Cardiovascular Imaging, vol. 16, no. 2, 2015, pp. 217-24.
Hasselberg NE, Haugaa KH, Sarvari SI, et al. Left ventricular global longitudinal strain is associated with exercise capacity in failing hearts with preserved and reduced ejection fraction. Eur Heart J Cardiovasc Imaging. 2015;16(2):217-24.
Hasselberg, N. E., Haugaa, K. H., Sarvari, S. I., Gullestad, L., Andreassen, A. K., Smiseth, O. A., & Edvardsen, T. (2015). Left ventricular global longitudinal strain is associated with exercise capacity in failing hearts with preserved and reduced ejection fraction. European Heart Journal Cardiovascular Imaging, 16(2), 217-24. https://doi.org/10.1093/ehjci/jeu277
Hasselberg NE, et al. Left Ventricular Global Longitudinal Strain Is Associated With Exercise Capacity in Failing Hearts With Preserved and Reduced Ejection Fraction. Eur Heart J Cardiovasc Imaging. 2015;16(2):217-24. PubMed PMID: 25552469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left ventricular global longitudinal strain is associated with exercise capacity in failing hearts with preserved and reduced ejection fraction. AU - Hasselberg,Nina E, AU - Haugaa,Kristina H, AU - Sarvari,Sebastian I, AU - Gullestad,Lars, AU - Andreassen,Arne K, AU - Smiseth,Otto A, AU - Edvardsen,Thor, Y1 - 2014/12/31/ PY - 2015/1/2/entrez PY - 2015/1/2/pubmed PY - 2015/11/13/medline KW - diastolic function KW - exercise testing KW - heart failure KW - myocardial mechanics KW - speckle tracking echocardiography SP - 217 EP - 24 JF - European heart journal cardiovascular Imaging JO - Eur Heart J Cardiovasc Imaging VL - 16 IS - 2 N2 - AIMS: Heart failure patients with reduced and preserved left ventricular (LV) ejection fraction (EF) show reduced exercise capacity. We explored the relationship between exercise capacity and systolic and diastolic myocardial function in heart failure patients. METHODS AND RESULTS: Exercise capacity, by peak oxygen uptake (VO2), was assessed in 100 patients (56 ± 12 years, NYHA functional class: 2.5 ± 0.9, EF: 42 ± 19%). LV systolic function, as EF and global longitudinal strain (GLS), and right ventricular function were assessed by echocardiography. Left atrial volume index and the ratio of peak early diastolic filling velocity (E) to early diastolic mitral annular velocity (e') were measures of diastolic function. Thirty-seven patients had heart failure with preserved EF (HFpEF), defined as EF ≥50% and echocardiographic diastolic dysfunction. LV GLS and peak pulmonary arterial systolic pressure were independently correlated to peak VO2 in the total study population and in HFpEF separately. LV GLS was superior to EF in identifying patients with impaired peak VO2 <20 mL/kg/min as shown by receiver operating characteristic analyses [areas under curves 0.93 (0.89-0.98) vs. 0.85 (0.77-0.93), P < 0.05]. In patients with HFpEF, GLS was reduced below normal (-17.5 ± 3.2%) and correlated to E/e' (R = 0.45, P = 0.005) and left atrial volume index (R = 0.48, P = 0.003), while EF did not. CONCLUSION: GLS correlated independently to peak VO2 in patients with reduced and preserved EF and was superior in identifying patients with reduced exercise capacity. In HFpEF, systolic function by GLS was impaired. There was a significant relationship between diastolic function and GLS, confirming a coupling between diastolic and longitudinal systolic function in HFpEF. SN - 2047-2412 UR - https://www.unboundmedicine.com/medline/citation/25552469/Left_ventricular_global_longitudinal_strain_is_associated_with_exercise_capacity_in_failing_hearts_with_preserved_and_reduced_ejection_fraction_ L2 - https://academic.oup.com/ehjcimaging/article-lookup/doi/10.1093/ehjci/jeu277 DB - PRIME DP - Unbound Medicine ER -