Evaluating left ventricular systolic function and synchronicity in patients with HFpEF using left ventricular pressure-strain loop combined with peak strain dispersion
Evaluating left ventricular systolic function and synchronicity in patients with HFpEF using left ventricular pressure-strain loop combined with peak strain dispersion
Objective To evaluate the alterations of left ventricular systolic function and synchronicity in patients with heart failure with preserved ejection fraction(HFpEF)using left ventricular pressure-strain loop combined with peak strain dispersion(PSD),left ventricular myocardial work parameters and PSD.Methods A total of 73 patients who met the diagnosis of HFpEF were selected as HFpEF group,and 68 healthy individuals who underwent physical examinations during the same period were selected as control group.Dynamic images of apical four chamber heart,apical long axis,and apical two chamber heart were collected for three consecutive cardiac cycles.Global longitudinal strain(GLS)and PSD were captured using two-dimensional speckle tracking technique.Real-time blood pressure of the patients was inputted to obtain myocardial work indicators,including global work index(GWI),global work efficiency(GWE),global constructive work(GCW),and global wasted work(GWW).The differences in various parameters were analyzed between two groups.The diagnostic values of GWE,GLS,and PSD were explored for patients with HFpEF.Results When compared to control group,GLS,GWI,GCW,and GWE in HFpEF group were decreased,while PSD and GWW were increased(P＜0.05).Correlation analysis showed that PSD in HFpEF group was negatively correlated with GLS and GWE(r=-0.366,-0.417,P＜0.05),while GWE was positively correlated with GLS(r=0.329,P＜0.05).GWE,GWW and GLS exhibited good diagnostic performance in predicting left ventricular systolic dysfunction in the patients with HFpEF,with areas under the curve(AUCs)of 0.853,0.840,and 0.861,respectively.The combined diagnosis of HFpEF using three parameters(GLS+GWE+PSD)had a AUC of 0.937,sensitivity of 94.52％and specificity of 82.35％.Conclusion Cardiac work parameters and peak strain dispersion can early and sensitively detect the alterations of systolic function and synchronous changes in HFpEF patients.The combined use of GLS,GWE and PSD can improve the performance in diagnosing HFpEF.
维普
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