Evidence of Left Ventricular Systolic Dysfunction Detected by Automated Function Imaging in Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction

Liu, Yen-Wen; Tsai, Wei-Chuan; Su, Chi-Ting; Lin, Chin-Chan; Chen, Jyh-Hong

doi:10.1016/j.cardfail.2009.05.006

« Previous Next »Journal of Cardiac Failure
Volume 15, Issue 9 , Pages 782-789, November 2009

Evidence of Left Ventricular Systolic Dysfunction Detected by Automated Function Imaging in Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction

Yen-Wen Liu, MD
- Department of Internal Medicine, National Cheng Kung University Medical Center, Tainan, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, Taiwan
Wei-Chuan Tsai, MD
- Department of Internal Medicine, National Cheng Kung University Medical Center, Tainan, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, 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.
Chi-Ting Su, MD
- Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan
Chin-Chan Lin, MD
- Department of Internal Medicine, National Cheng Kung University Medical Center, Tainan, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, Taiwan
Jyh-Hong Chen, MD, PhD
- Department of Internal Medicine, National Cheng Kung University Medical Center, Tainan, Taiwan

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.

Key Words: Heart failure with preserved left ventricular ejection fraction, automated function imaging, peak systolic longitudinal strain