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Predictive value of left ventricular myocardial strain by four‐dimensional speckle tracking echocardiography combined with red cell distribution width in heart failure with preserved ejection fraction
Author(s) -
Fang Sihua,
Zhang Zhihua,
Wang Ying,
Jiang Fan,
Yang Kai,
He Fei,
Zhang Chaoxue
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14373
Subject(s) - ejection fraction , medicine , cardiology , heart failure , red blood cell distribution width , speckle tracking echocardiography , diastole , blood pressure
Abstract Objectives The diagnostic difficulty of heart failure with preserved ejection fraction ( HF p EF ) is differentiating it in patients with similar symptoms and signs. This study aimed to assess the potential predictive value of left ventricular global longitudinal strain ( GLS ), global radial strain ( GRS ), global circumferential strain ( GCS ), and global area strain ( GAS ) measured by four‐dimensional speckle tracking echocardiography (4 DSTE ) combined with red cell distribution width ( RDW ) in patients with HF p EF . Methods One hundred and sixty‐nine patients with symptoms or signs indicative of chronic heart failure and a left ventricular ejection fraction ( LVEF ) ≥ 50% and fifty controls with normal LVEF were recruited in this study. Standard echocardiography and 4 DSTE examinations were performed. Laboratory examinations including RDW were performed on the same day as the echocardiographic study. Results GLS , GCS , GRS , and GAS in the patient cohort were significantly lower, and RDW was significantly higher than those in the control cohort ( P < 0.01), and the strain parameters in definite HF p EF patients were also dramatically lower than the rest patients ( P < 0.01). The associations of age, gender, NYHA classification, hypertension history, left ventricular end‐diastolic volume index, interventricular septal thickness, and diastolic dysfunction with HF p EF were significantly improved by adding 4 DSTE parameters ( P < 0.01) and further improved by adding RDW ( P < 0.01). Conclusions In suspected HF p EF patients, who have symptoms or signs of heart failure, even without other conventional evidence of this diagnosis, GLS , GRS , and GCS have potential independent predictive value, while RDW has independent incremental predictive value for HF p EF .