Correlation of left ventricular myocardial work indices with invasive measurement of stroke work in patients with advanced heart failure

Landra, Federico; Mandoli, Giulia Elena; Chiantini, Benedetta; Barilli, Maria; Merello, Giacomo; Carli, Giuseppe De; Sciaccaluga, Carlotta; Lisi, Matteo; Flamigni, Filippo; D’Ascenzi, Flavio; Focardi, Marta; Fineschi, Massimo; Iadanza, Alessandro; Bernazzali, Sonia; Maccherini, Massimo; Valente, Serafina; Cameli, Matteo

doi:10.3389/fcvm.2022.946540

Cited by 1 publication

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References 25 publications

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“…MW provides a deeper insight into myocardial performance by estimating pressure–deformation curves in a non-invasive way [ 10 , 11 , 12 , 13 , 14 ]. MW-derived parameters have demonstrated feasibility and applicability in patients with HF in different clinical contexts, among which are the characterization of patients with preserved LV EF [ 15 ], a correlation with invasively measured filling pressures [ 16 ] and support for mechanical circulatory support system optimization [ 17 ]. To the best of our knowledge, MW’s utility in predicting prognoses in AdHF patients has never been assessed.…”

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confidence: 99%

Myocardial Work Indices Predict Hospitalization in Patients with Advanced Heart Failure

Mandoli,

Landra,

Chiantini

et al. 2024

Diagnostics

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Background: An increasing proportion of heart failure (HF) patients progress to the advanced stage (AdHF) with high event rates and limited treatment options. Echocardiography, particularly Speckle Tracking-derived myocardial work (MW), is useful for HF diagnosis and prognosis. We aimed to assess MW’s feasibility in the prognostic stratification of AdHF. Methods: We retrospectively screened patients with AdHF who accessed our hospital in 2018–2022. We excluded subjects with inadequate acoustic windows; unavailable brachial artery cuff pressure at the time of the echocardiography; atrial fibrillation; and mitral or aortic regurgitation. We measured standard parameters and left ventricular (LV) strain (LS) and MW. The population was followed up to determine the composite outcomes of all-cause mortality, left ventricular assist device implantation and heart transplantation (primary endpoint), as well as unplanned HF hospitalization (secondary endpoint). Results: We enrolled 138 patients, prevalently males (79.7%), with a median age of 58 years (IQR 50–62). AdHF etiology was predominantly non-ischemic (65.9%). Thirty-five patients developed a composite event during a median follow-up of 636 days (IQR 323–868). Diastolic function, pulmonary pressures, and LV GLS and LV MW indices were not associated with major events. Contrarily, for the secondary endpoint, the hazard ratio for each increase in global work index (GWI) by 50 mmHg% was 0.90 (p = 0.025) and for each increase in global constructive work (GCW) by 50 mmHg% was 0.90 (p = 0.022). Kaplan–Meier demonstrated better endpoint-free survival, with an LV GWI ≥ 369 mmHg%. Conclusions: GWI and GCW, with good feasibility, can help in the better characterization of patients with AdHF at higher risk of HF hospitalization and adverse events, identifying the need for closer follow-up or additional HF therapy.

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