Significance of the echocardiographic evaluation of left atrial myocardial strain for early diagnosis of heart failure with preserved ejection fraction

Serezhina, E.K.; Обрезан, А. Г.

doi:10.18087/cardio.2021.8.n1418

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…При этом хроническое низкоинтенсивное воспаление при ГБ является дополнительным повреждающим фактором для органов-мишеней и ассоциировано с развитием неблагоприятных сердечно-сосудистых событий [20]. Таким образом, артериальная гипертензия, гиперинсулинемия, а также курение, представляют собой взаимосвязанные процессы, вызывающие изменения миокарда и сосудов, и потенциирующие хроническое низкоинтенсивное субклиническое воспаление органов и тканей [21][22][23].…”

Section: Discussionunclassified

Low-intensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction

Vitt,

Kuzheleva,

Tukish

et al. 2024

Cardiovasc Ther Prev

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Aim. To analyze the prognostic significance of clinical, anamnestic and paraclinical parameters in patients with heart failure with preserved ejection fraction (HFpEF) and non-obstructive coronary artery disease.Material and methods. The study included 54 patients. Cardiac and lung ultrasound was performed. In addition, the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), interleukin-1β, interleukin-18, growth differentiation factor 15 (GDF-15), and cryopyrin was determined. The level of quality of life, anxiety and depression, and adherence to treatment were analyzed.Results. The patients were divided into 2 following groups: group 1 (n=22) with an unfavorable course and group 2 (n=32) with a favorable disease course. Basic echocardiographic parameters, as well as the number of B-lines in lungs, were comparable in both groups. An unfavorable HFpEF course was associated with a longer history of hypertension — 17,5 [10;20] and 7 [5;15] years (p=0,03), smoking — 36,4 and 9,4% (p=0,035), impaired carbohydrate metabolism — 54,5 and 15,6% (p=0,003) and lower adherence to treatment (p=0,02). In group 1, GDF-15 levels were higher than in group 2 — 1841 [1237;3552] vs 1709,5 [1158;2492] pg/ml (p=0,026).Conclusion. Low-intensity subclinical inflammation, the predisposing factors of which are smoking, impaired carbohydrate metabolism, and a long history of hypertension, is associated with higher GDF-15 values in patients with HFpEF and, along with low patient adherence to treatment, has an adverse effect on the clinical course of heart failure.

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Section: Discussionunclassified

Low-intensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction

Vitt,

Kuzheleva,

Tukish

et al. 2024

Cardiovasc Ther Prev

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“…Критерии включения: ДД со снижением ранней диастолической скорости движения фиброзного кольца митрального клапана, оцененной при помощи тканевой допплерографии (Tissue Doppler Imaging, TDI); недостаточное количество критериев для заключения о повышенном ДЗ ЛЖ по данным традиционной ЭхоКГ покоя (отсутствие 2-х либо 3-х положительных критериев из 3-х возможных). Учитывали отношение Е/е' (отношение ранней диасто- шении анализа фазовой деформации ЛП, который может получить более широкое распространение [3,4,16,17]. Неспособность миокарда ЛЖ к адекватному растяжению и прогрессирующее увеличение ДЗ ЛЖ в раннюю диастолу описывается ростом отношения E/e'; угнетение растяжения стенок ЛП в резервуарную фазу/увеличение среднего давления в ЛП выражается снижением LASr [3].…”

Section: материал и методыunclassified

Left atrial stiffness index in the identification of heart failure with preserved ejection fraction

Shirokov,

Yaroslavskaya,

Kosterin

et al. 2024

Cardiovasc Ther Prev

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Aim. To study the diagnostic value of the left atrial stiffness index (LASI) of heart failure with preserved ejection fraction (HFpEF) depending assessed by transthoracic echocardiography (TTE) in the diagnosis on diastolic stress test (DST) results.Material and methods. DST was performed in cases of insufficient criteria for increased left ventricular filling pressure assessed by TTE. One hundred patients were examined (52,0% men, 66,1±5,4 years). Patients with a ratio of early transmitral flow velocity to early diastolic mitral annulus velocity (E/e') ratio >15 in DST were included in group I (n=45), patients with E/e' <15 — group II (n=55). The speckle tracking echocardiography was used to assess left atrial reservoir strain (LASr).Results. Significant differences were identified between the groups in sex (40,0% of men in group I and 61,8% in group II, respectively; p=0,044), body mass index (32,9 [29,5;36,0] and 29,6 [27,3;31,8] kg/m2; p=0,001), hypertension stage (2,9±0,3 and 2,5±0,8, p=0,037), the presence of coronary artery disease (88,9 and 67,3%; p=0,016), NYHA heart failure class (2,0±0,4 and 1,5±0,7; p=0,003). TTE revealed significant differences in the left atrium volume index (31,9 [28,5;36,0] and 27,8 [24,1;34,6] ml/m2; p=0,039), E/e' ratio (10,9 [9,7;12,5] and 9,3 [7,4;10,8]; p<0,001), LASr (23,5 [19,3;28,3] and 28,9 [25,6;32,2]%, p<0,001) and LASI (0,46 [0,38;0,56] and 0,30 [0,25;0,39]; p<0,001). According to ROC analysis, the largest area under the curve (AUC), optimal sensitivity and specificity in HFpEF diagnosis were observed in LASI (AUC=0,829, p<0,001; 77,8 and 74,5%, respectively). Lower classification quality was shown by the H2FPEF score (AUC=0,701, p=0,001; 66,7 and 69,1%), while the HFA-PEFF score was not significant in the pretest detection of HFpEF (AUC=0,608, p=0,065; 53,3 and 61,8%).Conclusion. LASI with a cut-off point >0,38 has the greatest ability to detect HFpEF among the possible pretest diagnostic methods.

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“…Из изложенного следует, что при применении STE в диагностике СНсФВ именно анализ LASr может привести к своевременным терапевтическим вмешательствам (в дополнение к HFA-PEFF и H2FPEF) [24]. А в цепочке связанных структур, действующих последовательно и комплексно, функциональная связь ЛЖ и ЛП (LASI) может являться ключевым компонентом континуума ремоделирования левых отделов сердца (табл.…”

Section: рис 2 фазовый анализ Lasunclassified

Principles for diagnosing heart failure with preserved ejection fraction

Shirokov,

Yaroslavskaya,

Krinochkin

et al. 2023

Russ J Cardiol

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Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.

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Significance of the echocardiographic evaluation of left atrial myocardial strain for early diagnosis of heart failure with preserved ejection fraction

Cited by 5 publications

References 33 publications

Low-intensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction

Low-intensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction

Left atrial stiffness index in the identification of heart failure with preserved ejection fraction

Principles for diagnosing heart failure with preserved ejection fraction

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