Evidence of Left Ventricular Systolic Dysfunction Detected by Automated Function Imaging in Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction
Received 11 February 2009; received in revised form 5 May 2009; accepted 11 May 2009. published online 25 June 2009.
Abstract
Background
Left ventricular ejection fraction (LVEF) cannot reflect cardiac contractile function in patients with heart failure and preserved LVEF (HFPEF). LV systolic impairment is actually debated in HFPEF patients. Automated function imaging (AFI) is a novel algorithm of speckle-tracking echocardiography and efficiently to assess global LV peak systolic longitudinal strain (PSLS), an index for systolic function. The purpose of the study is to examine whether contractile function is impaired in HFPEF patients.
Methods and Results
This study included 49 heart failure patients (23 with systolic dysfunction [SHF] and 26 with HFPEF), and 40 patients, matched for age, sex, as well as concomitant disease and without heart failure as controls. All patients underwent transthoracic echocardiography. LVEF was measured by Simpson's method. Two-dimensional speckle tracking imaging with AFI assessment was applied to measure longitudinal strain. LVEF was 66±5% in the controls, 63±8% in the HFPEF group (P=.14), and 34±10% in the SHF group (P < .001). The value of LV global PSLS (controls: –20%, HFPEF: –14%, SHF: –8%, P < .001) was significantly less negative in both heart failure groups.
Conclusions
Deteriorated LV systolic function is demonstrated by decreased global PSLS in HFPEF patients. AFI is an effective and facile method for assessing LV systolic abnormalities.
1Department of Internal Medicine, National Cheng Kung University Medical Center, Tainan, Taiwan
2Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, Taiwan
3Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan
Correspondence to: Wei-Chuan Tsai, MD, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, Taiwan, 345, Chuang-Ching Rd. Dou-Liou City 640, Yun-Lin County, Taiwan. Tel: 886-5-5322017; Fax: 886-5-5334521.
ABSTRACT