New echocardiographic parameters in the diagnosis of heart failure with preserved ejection fraction

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a serious clinical disease. The pathophysiology of HFpEF is complex, and specific diagnostic criteria have evolved over time. Limited data are available on the quantification of diastolic function using two-dimensional real-time echocardiography, and a simple parameter has not yet been established. The aim of this work is to evaluate new echocardiographic parameters-the diastolic wall strain of the posterior wall (DWS PW) and the vortex formation time (VFT). Echocardiographic data from 111 subjects with exertional dyspnea and normal left ejection fraction (Group A) and 20 healthy volunteers (Group B) were retrospectively evaluated. In addition to the standard parameters used in the diagnosis of HFpEF, DWS PW and VFT were assessed in all patients. HFpEF was diagnosed in 38 patients with dyspnea (Group A1). The remaining 73 patients did not meet the established criteria for a positive diagnosis of HFpEF (Group A2). We discovered that both observed parameters were significantly lower in patients with HFpEF than in other groups. Multivariate analysis revealed that both DWS PW and VFT independently predicted the presence of HFpEF. DWS PW and VFT are simple parameters in the evaluation of diastolic function and may play a potential role as a part of an integrated approach to the assessment of HFpEF.

Vortex Formation Time is a Novel Measure for Early Detection of Diastolic Abnormalities in Adolescents with Hypertension

“…This study corroborates those ndings for pediatric HTN, indicating that adolescents with HTN display signi cantly lower VFT than adolescents without HTN. These ndings also provide support for previous studies which have observed lower VFT values in adult patients with diastolic dysfunction, as adolescents with higher SBP displayed lower VFT [26,31,32].…”

Non‐severe aortic regurgitation increases short‐term mortality in acute heart failure with preserved ejection fraction

“…In the normal heart, the vortex is responsible for entering about 13% the filling volume, while this portion is reduced to 5% in hypertrophic cardiomyopathy 27 . Impaired generation of this swirling structure has also been shown in HFpEF, 28 and perturbation of the vortex function has been associated with increased cardiovascular mortality and rehospitalization 29 . Biomechanical models of the left ventricle have visualized that the regurgitant jet of mild or moderate AR impedes vortex formation as a function of its severity, 30 suggesting that already a small regurgitant volume should worsen the pre‐existing pathologic vortex formation in patients with preserved LVEF.…”

Serum and Echocardiographic Markers May Synergistically Predict Adverse Cardiac Remodeling after ST-Segment Elevation Myocardial Infarction in Patients with Preserved Ejection Fraction

“…Currently, >70% of patients with CHF aged >65 years have a preserved LVEF (HFpEF), and this proportion tends to increase together with the rising prevalence of associated underlying health conditions (obesity, metabolic syndrome, and diabetes mellitus) [10]. In contrast to CHF with a reduced (<50%) LVEF (HFrEF), which progression can be directly assessed in a noninvasive manner by echocardiography, efficient monitoring of the cardiac status in the patients with HFpEF is challenging [11], although a number of studies in this direction have been reported [12,13]. Taken together, these facts underscore the importance of finding the informative and routinely measurable biomarkers of ventricular remodeling in this patient category [14].…”