Sihua Fang1, Zhihua Zhang2, Ying Wang2, Fan Jiang3, Kai Yang4, Fei He5, Chaoxue Zhang1. 1. Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Hefei, China. 2. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China. 3. Department of Ultrasound, the Second Affiliated Hospital of Anhui Medical University, Hefei, China. 4. Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University, Hefei, China. 5. Department of Cardiovascular Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Abstract
OBJECTIVES: The diagnostic difficulty of heart failure with preserved ejection fraction (HFpEF) is differentiating it in patients with similar symptoms and signs. This study aimed to assess the potential predictive value of left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) measured by four-dimensional speckle tracking echocardiography (4DSTE) combined with red cell distribution width (RDW) in patients with HFpEF. METHODS: One hundred and sixty-nine patients with symptoms or signs indicative of chronic heart failure and a left ventricular ejection fraction (LVEF) ≥ 50% and fifty controls with normal LVEF were recruited in this study. Standard echocardiography and 4DSTE examinations were performed. Laboratory examinations including RDW were performed on the same day as the echocardiographic study. RESULTS: GLS, GCS, GRS, and GAS in the patient cohort were significantly lower, and RDW was significantly higher than those in the control cohort (P < 0.01), and the strain parameters in definite HFpEF patients were also dramatically lower than the rest patients (P < 0.01). The associations of age, gender, NYHA classification, hypertension history, left ventricular end-diastolic volume index, interventricular septal thickness, and diastolic dysfunction with HFpEF were significantly improved by adding 4DSTE parameters (P < 0.01) and further improved by adding RDW (P < 0.01). CONCLUSIONS: In suspected HFpEF patients, who have symptoms or signs of heart failure, even without other conventional evidence of this diagnosis, GLS, GRS, and GCS have potential independent predictive value, while RDW has independent incremental predictive value for HFpEF.
OBJECTIVES: The diagnostic difficulty of heart failure with preserved ejection fraction (HFpEF) is differentiating it in patients with similar symptoms and signs. This study aimed to assess the potential predictive value of left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) measured by four-dimensional speckle tracking echocardiography (4DSTE) combined with red cell distribution width (RDW) in patients with HFpEF. METHODS: One hundred and sixty-nine patients with symptoms or signs indicative of chronic heart failure and a left ventricular ejection fraction (LVEF) ≥ 50% and fifty controls with normal LVEF were recruited in this study. Standard echocardiography and 4DSTE examinations were performed. Laboratory examinations including RDW were performed on the same day as the echocardiographic study. RESULTS: GLS, GCS, GRS, and GAS in the patient cohort were significantly lower, and RDW was significantly higher than those in the control cohort (P < 0.01), and the strain parameters in definite HFpEF patients were also dramatically lower than the rest patients (P < 0.01). The associations of age, gender, NYHA classification, hypertension history, left ventricular end-diastolic volume index, interventricular septal thickness, and diastolic dysfunction with HFpEF were significantly improved by adding 4DSTE parameters (P < 0.01) and further improved by adding RDW (P < 0.01). CONCLUSIONS: In suspected HFpEF patients, who have symptoms or signs of heart failure, even without other conventional evidence of this diagnosis, GLS, GRS, and GCS have potential independent predictive value, while RDW has independent incremental predictive value for HFpEF.
Authors: Michiel T H M Henkens; Sharon Remmelzwaal; Emma L Robinson; Adriana J van Ballegooijen; Arantxa Barandiarán Aizpurua; Job A J Verdonschot; Anne G Raafs; Jerremy Weerts; Mark R Hazebroek; Sandra Sanders-van Wijk; M Louis Handoko; Hester M den Ruijter; Carolyn S P Lam; Rudolf A de Boer; Walter J Paulus; Vanessa P M van Empel; Rein Vos; Hans-Peter Brunner-La Rocca; Joline W J Beulens; Stephane R B Heymans Journal: Eur J Heart Fail Date: 2020-08-07 Impact factor: 15.534