Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction
Abstract Aims Some patients with apparent heart failure (HF) have an ejection fraction (EF) ≥ 50% and elevated levels of natriuretic peptides (NPs), but no significant diastolic dysfunction. Among these, some may have HF, others may not. Myocardial strain is an excellent prognostic factor. Methods a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.14078 |
| _version_ | 1797794263393632256 |
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| author | Jin Joo Park In‐Chang Hwang Si‐Hyuck Kang Jun‐Bean Park Jae‐Hyeong Park Goo‐Yeong Cho |
| author_facet | Jin Joo Park In‐Chang Hwang Si‐Hyuck Kang Jun‐Bean Park Jae‐Hyeong Park Goo‐Yeong Cho |
| author_sort | Jin Joo Park |
| collection | DOAJ |
| description | Abstract Aims Some patients with apparent heart failure (HF) have an ejection fraction (EF) ≥ 50% and elevated levels of natriuretic peptides (NPs), but no significant diastolic dysfunction. Among these, some may have HF, others may not. Myocardial strain is an excellent prognostic factor. Methods and results Among 4312 consecutive patients with acute HF from three tertiary hospitals, we included 355 patients with EF of ≥50% and elevated levels of NPs, without significant diastolic dysfunction. Patients were classified as having impaired global longitudinal strain (GLS < 16%) or normal GLS (GLS ≥ 16%). The primary endpoint was 5 year all‐cause mortality. The mean age was 70.3 years and 49% were female. Overall, 107 patients (30.1%) died at 5 years. As per the definition, 176 (49.6%) patients had impaired GLS and 179 (50.4%) had normal GLS. Patients with normal GLS had lower 5 year all‐cause mortality than those with impaired GLS (P < 0.001). When comparing with the 11 365 age‐matched and sex‐matched controls, patients with normal GLS had the same long‐term survival as the controls (P = 0.834), whereas those with impaired GLS had 48% increased risk of all‐cause mortality (hazard ratio, 1.48; 95% confidence interval, 1.17–1.89). Conclusions Among patients with apparent HF and preserved EF but without diastolic dysfunction, those with impaired GLS may be considered to have HF. |
| first_indexed | 2024-03-13T03:00:12Z |
| format | Article |
| id | doaj.art-0196b9920ae043efba74229cd961b9b2 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-13T03:00:12Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-0196b9920ae043efba74229cd961b9b22023-06-27T14:49:57ZengWileyESC Heart Failure2055-58222022-10-01953308331610.1002/ehf2.14078Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunctionJin Joo Park0In‐Chang Hwang1Si‐Hyuck Kang2Jun‐Bean Park3Jae‐Hyeong Park4Goo‐Yeong Cho5Cardiovascular Center and Department of Internal Medicine, Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaCardiovascular Center and Department of Internal Medicine, Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaCardiovascular Center and Department of Internal Medicine, Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaDepartment of Internal Medicine, Seoul National University College of Medicine Seoul National University Hospital Seoul Republic of KoreaDepartment of Cardiology in Internal Medicine, Chungnam National University Hospital Chungnam National University College of Medicine Daejeon Republic of KoreaCardiovascular Center and Department of Internal Medicine, Seoul National University College of Medicine Seoul National University Bundang Hospital Seongnam Republic of KoreaAbstract Aims Some patients with apparent heart failure (HF) have an ejection fraction (EF) ≥ 50% and elevated levels of natriuretic peptides (NPs), but no significant diastolic dysfunction. Among these, some may have HF, others may not. Myocardial strain is an excellent prognostic factor. Methods and results Among 4312 consecutive patients with acute HF from three tertiary hospitals, we included 355 patients with EF of ≥50% and elevated levels of NPs, without significant diastolic dysfunction. Patients were classified as having impaired global longitudinal strain (GLS < 16%) or normal GLS (GLS ≥ 16%). The primary endpoint was 5 year all‐cause mortality. The mean age was 70.3 years and 49% were female. Overall, 107 patients (30.1%) died at 5 years. As per the definition, 176 (49.6%) patients had impaired GLS and 179 (50.4%) had normal GLS. Patients with normal GLS had lower 5 year all‐cause mortality than those with impaired GLS (P < 0.001). When comparing with the 11 365 age‐matched and sex‐matched controls, patients with normal GLS had the same long‐term survival as the controls (P = 0.834), whereas those with impaired GLS had 48% increased risk of all‐cause mortality (hazard ratio, 1.48; 95% confidence interval, 1.17–1.89). Conclusions Among patients with apparent HF and preserved EF but without diastolic dysfunction, those with impaired GLS may be considered to have HF.https://doi.org/10.1002/ehf2.14078Heart failurePreserved ejection fractionNo diastolic dysfunctionMyocardial strainInvisible HFAll‐cause mortality |
| spellingShingle | Jin Joo Park In‐Chang Hwang Si‐Hyuck Kang Jun‐Bean Park Jae‐Hyeong Park Goo‐Yeong Cho Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction ESC Heart Failure Heart failure Preserved ejection fraction No diastolic dysfunction Myocardial strain Invisible HF All‐cause mortality |
| title | Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction |
| title_full | Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction |
| title_fullStr | Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction |
| title_full_unstemmed | Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction |
| title_short | Myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction |
| title_sort | myocardial strain for heart failure with preserved ejection fraction but without diastolic dysfunction |
| topic | Heart failure Preserved ejection fraction No diastolic dysfunction Myocardial strain Invisible HF All‐cause mortality |
| url | https://doi.org/10.1002/ehf2.14078 |
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