Speckle tracking echocardiography-determined measures of global and regional left ventricular function correlate with functional capacity in patients with and without preserved ejection fraction

Abstract

BackgroundStandard measures of left ventricular systolic and diastolic function often fail to identify left ventricular dysfunction in patients with heart failure and do not correlate with measures of functional capacity.AimTo determine if speckle tracking echocardiography (STE)–determined measures of global and regional myocardial contractility have a linear association with functional capacity in patients with and without preserved ejection fraction.MethodsIn 68 adult patients, functional status was estimated with the Duke Activity Status Index (DASI), left ventricular ejection fraction was determined with Simpson’s biplane method, and QLAB advanced quantification software (Philips, The Netherlands) was used to determine peak measures of strain.ResultsGlobal and regional measures of longitudinal, circumferential, and radial strain had a strong linear association with the DASI score. Longitudinal strain in the inferolateral segments had the strongest correlation with DASI (r = −0.72, P < 0.001). In patients with an ejection fraction ≥45%, ejection fraction and E/e’ had no correlation with DASI, whereas longitudinal strain in the inferolateral segments had significant correlation with DASI (r = −0.53, P = 0.03, n = 16).ConclusionsSTE–determined measures of global and regional left ventricular function have a strong linear association with estimates of functional capacity in patients with and without preserved ejection fraction. STE–determined measures of strain, especially longitudinal strain, are likely to be important targets for therapy and should be considered in future studies aimed at improving our diagnosis of left ventricular inadequacy in patients with heart failure, especially those with preserved ejection fraction.

Left ventricle ejection fraction and strain derived by three-dimensional echocardiography are associated with exercise capacity in the patients with heart failure

“…However, in our clinical center, the CPET is widely used in the clinical assessment of patients with HF and the main objective of this study was to explore the relationship between the exercise capacity parameters (VO 2, VE/VCO 2 ) and 3D-STE imaging of LV function in the HF patients with reduced LVEF. We observed a significantly positive correlation between the peak VO 2 values and parameters of 3DE, and a significantly negative correlation between the VE/VCO 2 slope values and the parameters of 3DE which is in agreement with the previously reported results 34,35 . Namely, Peterson et al 34 stated that the 3D-STE measures had a strong linear association with estimates of functional capacity.…”

“…We observed a significantly positive correlation between the peak VO 2 values and parameters of 3DE, and a significantly negative correlation between the VE/VCO 2 slope values and the parameters of 3DE which is in agreement with the previously reported results 34,35 . Namely, Peterson et al 34 stated that the 3D-STE measures had a strong linear association with estimates of functional capacity. Additionally, Donal et al 35 reported a moderate correlation between 3D-STE and the functional capacity parameters.…”

Regional ejection fraction and regional area strain for left ventricular function assessment in male patients after first-time myocardial infarction

“…However, the potential accuracy of the method in computing the myocardium wall strains has yet to be confirmed by a first patient study [12]. Three-dimensional speckle tracking echocardiography is also widely adopted for measuring the circumferential, radial and longitudinal strains in the myocardium [13,14]. Kleijn et al [15] determined the regional function of the myocardium based on automatic wall motion analysis using three-dimensional speckle tracking echocardiography.…”

Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction

“…Despite current therapeutic approaches, HFpEF related mortality remains high, and no specific treatment has proved effective . In those patients, studies identified different echocardiographic predictors of clinical outcome, quality of life and functional capacity . Also in them, limited exercise capacity and deteriorating quality of life correlated with poor prognosis similar to patients with heart failure with reduced ejection fraction (HFrEF) .…”

“…3,4 In those patients, studies identified different echocardiographic predictors of clinical outcome, [5][6][7] quality of life 8,9 and functional capacity. 10,11 Also in them, limited exercise capacity and deteriorating quality of life correlated with poor prognosis similar to patients with heart failure with reduced ejection fraction (HFrEF). 12,13 Although the most accurate surrogate of functional capacity is peak oxygen uptake (peak VO 2 ), 14 its assessment is limited in daily clinical practice.…”