Usefulness and clinical relevance of left ventricular global longitudinal systolic strain in patients with heart failure with preserved ejection fraction

Tschöpe, Carsten; Senni, Michele

doi:10.1007/s10741-019-09853-7

Cited by 17 publications

(17 citation statements)

References 86 publications

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“…Up to two thirds of HFpEF patients show abnormal GLS despite preserved EF [61,62]. This reflects the complexity of HFpEF pathophysiology, with preclinical systolic dysfunction as yet another contributor to HFpEF syndrome [63][64][65].…”

Section: Step 2 (E): Echocardiographic and Np Scorementioning

confidence: 98%

On the search for the right definition of heart failure with preserved ejection fraction

et al. 2020

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The definition of heart failure with preserved ejection fraction (HFpEF) has evolved from a clinically based "diagnosis of exclusion" to definitions focused on objective evidence of diastolic dysfunction and/ /or elevated left ventricular filling pressures. Despite advances in our understanding of HFpEF pathophysiology and the development of more sophisticated imaging modalities, the diagnosis of HFpEF remains challenging, especially in the chronic setting, given that symptoms are provoked by exertion and diagnostic evaluation is largely conducted at rest. Invasive hemodynamic study, and in particularinvasive exercise testing, is considered the reference method for HFpEF diagnosis. However, its use is limited as opposed to the high number of patients with suspected HFpEF. Thus, diagnostic criteria for HFpEF should be principally based on non-invasive measurements. As no single non-invasive variable can adequately corroborate or refute the diagnosis, different combinations of clinical, echocardiographic, and/or biochemical parameters have been introduced. Recent years have brought an abundance of HF-pEF definitions. Here, we present and compare four of them: 1) the 2016 European Society of Cardiology criteria for HFpEF; 2) the 2016 echocardiographic algorithm for diagnosing diastolic dysfunction; 3) the 2018 evidence-based H 2 FPEF score; and 4) the most recent, 2019 Heart Failure Association HFA-PEFF algorithm. These definitions vary in their approach to diagnosis, as well as sensitivity and specificity. Further studies to validate and compare the diagnostic accuracy of HFpEF definitions are warranted. Nevertheless, it seems that the best HFpEF definition would originate from a randomized clinical trial showing a favorable effect of an intervention on prognosis in HFpEF.

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Section: Step 2 (E): Echocardiographic and Np Scorementioning

confidence: 98%

On the search for the right definition of heart failure with preserved ejection fraction

et al. 2020

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“…LV longitudinal systolic dysfunction identified by STE imaging is common among patients affected by HFpEF [ 8 , 9 , 10 ]. This is because HFpEF comorbid conditions, such as type 2 diabetes, systemic arterial hypertension, history of coronary artery disease, obesity, and severe LV hypertrophy, often cause interstitial fibrosis, which primarily involves LV subendocardial fibers [ 11 ]. Therefore, HFpEF is now considered a disorder characterized, not only by isolated LV diastolic dysfunction, but also by LV systolic longitudinal abnormalities.…”

Section: Left Ventricular Speckle Tracking Echocardiographymentioning

confidence: 99%

“…The isolated impairment of the subendocardial layer is compensated by the augmentation of function of the other layers, so that LVEF and overall LV performance remain preserved [ 2 , 11 ]. Thus, longitudinal systolic dysfunction in patients with HFpEF is counteracted by a normal rotational, circumferential and radial LV contraction.…”

Section: Left Ventricular Speckle Tracking Echocardiographymentioning

confidence: 99%

“…Finally, abnormal GLS during exercise has been found to be an independent predictor of the occurrence of all-cause death and HF hospitalization in patients with HFpEF [ 15 ]. Probably, LV longitudinal systolic dysfunction can favor the insufficient rise of stroke volume and cardiac output during exercise, mechanism which may contribute to reduced functional capacity during effort in patients with HFpEF [ 11 ].…”

Section: Left Ventricular Speckle Tracking Echocardiographymentioning

confidence: 99%

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Left Ventricular Deformation and Vortex Analysis in Heart Failure: From Ultrasound Technique to Current Clinical Application

et al. 2021

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Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality. However, its symptoms and signs are not specific or can be absent. In this context, transthoracic echocardiography plays a key role in diagnosing the various forms of HF, guiding therapeutic decision making and monitoring response to therapy. Over the last few decades, new ultrasound modalities have been introduced in the field of echocardiography, aiming at better understanding the morpho-functional abnormalities occurring in cardiovascular diseases. However, they are still struggling to enter daily and routine use. In our review article, we turn the spotlight on some of the newest ultrasound technologies; in particular, analysis of myocardial deformation by speckle tracking echocardiography, and intracardiac flow dynamics by color Doppler flow mapping, highlighting their promising applications to HF diagnosis and management. We also focus on the importance of these imaging modalities in the selection of responses to cardiac resynchronization therapy.

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“…A normal healthy heart stretches just before isovolumic relaxation (Rosen et al, 2004), and hearts of patients with hypertension and hypertrophy lose this lengthening strain (Saito et al, 2011). Recent studies report that cardiac global longitudinal strain is impaired in patients suffering from heart failure with preserved ejection fraction (Tschöpe and Senni, 2020). Integrating these clinical data, the results of Brutsaert et al (1984), and our computational modeling (using a simple two-state crossbridge model), we previously suggested that there is a strain rate-dependent detachment of crossbridges, resetting myosin's ATPase cycle (Chung et al, 2017).…”

mentioning

confidence: 99%

Move quickly to detach: Strain rate–dependent myosin detachment and cardiac relaxation

Chung

2020

Journal of General Physiology

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Usefulness and clinical relevance of left ventricular global longitudinal systolic strain in patients with heart failure with preserved ejection fraction

Cited by 17 publications

References 86 publications

On the search for the right definition of heart failure with preserved ejection fraction

On the search for the right definition of heart failure with preserved ejection fraction

Left Ventricular Deformation and Vortex Analysis in Heart Failure: From Ultrasound Technique to Current Clinical Application

Move quickly to detach: Strain rate–dependent myosin detachment and cardiac relaxation

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