Author + information
- Angela B.S. Santos,
- Elisabeth Kraigher-Krainer,
- Michael Zile,
- Burkert Pieske,
- Adriaan A. Voors,
- John J.V. McMurray,
- Milton Packer,
- Toni Bransford,
- Marty Lefkowitz,
- Amil Shah and
- Scott D. Solomon
Mechanical dyssynchrony has been proposed to play a pathophysiologic role in heart failure with preserved ejection fraction (HFpEF).
We quantified LV systolic and diastolic function and dyssynchrony in 210 HFpEF patients with NYHA class II-IV symptoms, EF >45%, and NT-proBNP levels >400 pg/mL enrolled in the PARAMOUNT trial, and compared them to 20 age-matched-healthy controls. Dyssynchrony was assessed by 2D speckle-tracking as standard deviation (SD) of time to peak longitudinal strain.
HFpEF sample consisted of 63% women, mean age of 71+9y, body mass index (BMI) of 30.3+6kg/m2, systolic blood pressure (SBP) of 136+15mmHg. HFpEF patients had significantly greater dyssynchrony compared to controls (SD of time to peak longitudinal strain 99+50 vs 50+28ms, p=0.0001), even after adjustment by differences in baseline (gender, BMI and SBP). Greater dyssynchrony was associated with greater QRS duration, worse global longitudinal strain, lower TDI E', and higher E/E'. Greater dyssynchrony remained significantly associated with lower E’ even after restricting analysis to patients with narrow QRS complex (QRS<120ms) and EF>55% (n=113; p=0.047).
HFpEF patients demonstrate greater LV dyssynchrony compared to age-matched healthy controls and this dyssynchrony is associated with worse systolic and diastolic function. Whether reduced myocardial contractile efficiency due to modest dyssynchrony contributes to the syndrome of HFpEF remains to be determined.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: LV Diastolic Function
Abstract Category: 18. Imaging: Echo
Presentation Number: 1143-363
- 2013 American College of Cardiology Foundation