New echocardiographic parameters in the diagnosis of heart failure with preserved ejection fraction

Int J Cardiovasc Imaging. 2018 Feb;34(2):229-235. doi: 10.1007/s10554-017-1230-z. Epub 2017 Aug 17.

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a serious clinical disease. The pathophysiology of HFpEF is complex, and specific diagnostic criteria have evolved over time. Limited data are available on the quantification of diastolic function using two-dimensional real-time echocardiography, and a simple parameter has not yet been established. The aim of this work is to evaluate new echocardiographic parameters-the diastolic wall strain of the posterior wall (DWS PW) and the vortex formation time (VFT). Echocardiographic data from 111 subjects with exertional dyspnea and normal left ejection fraction (Group A) and 20 healthy volunteers (Group B) were retrospectively evaluated. In addition to the standard parameters used in the diagnosis of HFpEF, DWS PW and VFT were assessed in all patients. HFpEF was diagnosed in 38 patients with dyspnea (Group A1). The remaining 73 patients did not meet the established criteria for a positive diagnosis of HFpEF (Group A2). We discovered that both observed parameters were significantly lower in patients with HFpEF than in other groups. Multivariate analysis revealed that both DWS PW and VFT independently predicted the presence of HFpEF. DWS PW and VFT are simple parameters in the evaluation of diastolic function and may play a potential role as a part of an integrated approach to the assessment of HFpEF.

Keywords: Diastolic wall strain; Heart failure with preserved ejection fraction; Vortex formation time.

MeSH terms

  • Aged
  • Biomechanical Phenomena
  • Echocardiography, Doppler*
  • Female
  • Heart Failure / diagnostic imaging*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Models, Cardiovascular
  • Multivariate Analysis
  • Myocardial Contraction*
  • Predictive Value of Tests
  • Prognosis*
  • Retrospective Studies
  • Stroke Volume*
  • Ventricular Function, Left*