Kerstens, TP, Weerts, J, van Dijk, APJ, Weijers, G, Knackstedt, C, Eijsvogels, TMH, Oxborough, D, van Empel, VPM and Thijssen, DHJ (2023) Left ventricular strain-volume loops and diastolic dysfunction in suspected heart failure with preserved ejection fraction. International Journal of Cardiology, 378. pp. 144-150. ISSN 1874-1754

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Abstract

BACKGROUND: Presence of left ventricular diastolic dysfunction (DD) is key in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). However, non-invasive assessment of diastolic function is complex, cumbersome, and largely based on consensus recommendations. Novel imaging techniques may help detecting DD. Therefore, we compared left ventricular strain-volume loop (SVL) characteristics and diastolic (dys-)function in suspected HFpEF patients.
METHOD AND RESULTS: 257 suspected HFpEF patients with sinus rhythm during echocardiography were prospectively included. 211 patients with quality-controlled images and strain and volume analysis were classified according to the 2016 ASE/EACVI recommendations. Patients with indeterminate diastolic function were excluded, resulting in two groups: normal diastolic function (control; n = 65) and DD (n = 91). Patients with DD were older (74.8 ± 6.9 vs. 68.5 ± 9.4 years, p < 0.001), more often female (88% vs 72%, p = 0.021), and more often had a history of atrial fibrillation (42% vs. 23%, p = 0.024) and hypertension (91% vs. 71%, p = 0.001) compared to normal diastolic function. SVL analysis showed a larger uncoupling i.e., a different longitudinal strain contribution to volume change, in DD compared to controls (0.556 ± 1.10% vs. -0.051 ± 1.14%, respectively, P < 0.001). This observation suggests different deformational properties during the cardiac cycle. After adjustment for age, sex, history of atrial fibrillation and hypertension, we found an adjusted odds ratio of 1.68 (95% confidence interval 1.19-2.47) for DD per unit increase in uncoupling (range: -2.95-3.20).
CONCLUSION: Uncoupling of the SVL is independently associated with DD. This might provide novel insights in cardiac mechanics and new opportunities to assess diastolic function non-invasively.

Item Type:	Article
Uncontrolled Keywords:	Diastolic dysfunction; Echocardiography; Speckle tracking imaging; Strain volume loop; 1102 Cardiorespiratory Medicine and Haematology; 1117 Public Health and Health Services; Cardiovascular System & Hematology
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport & Exercise Sciences
Publisher:	Elsevier
SWORD Depositor:	A Symplectic
Date Deposited:	01 Mar 2023 12:56
Last Modified:	05 Apr 2023 09:00
DOI or ID number:	10.1016/j.ijcard.2023.01.084
URI:	https://researchonline.ljmu.ac.uk/id/eprint/19013

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