Global longitudinal strain by two-dimensional speckle tracking imaging predicts exercise capacity in patients with chronic heart failure
Tóm tắt
Left ventricular ejection fraction (LVEF) predicts mortality in patients with chronic heart failure (CHF). However, a weak correlation was found between LVEF and peak oxygen uptake (
$$ \dot{V}{\text{O}}_{2} $$
) in CHF patients. Global longitudinal strain measured by two-dimensional (2D) strain is regarded as a more useful predictor of cardiac events than LVEF. We investigated whether 2D strain obtained at rest could predict peak
$$ \dot{V}{\text{O}}_{2} $$
in patients with CHF. Fifty-one patients (mean age of 54.0 ± 12.0 years, 14 females, LVEF 46.0 ± 15.0%) with stable CHF underwent resting echocardiography and cardiopulmonary exercise testing. Leg muscle strength was measured for the evaluation of peripheral factors. Global longitudinal strain (GLS) in the apical 4-, 3-, and 2-chamber views and global circumferential strain (GCS) in the parasternal mid short-axis view were measured. In all patients, peak
$$ \dot{V}{\text{O}}_{2} $$
correlated with leg muscle strength (r = 0.55, p < 0.0001), LVEF (r = 0.46, p < 0.001), GLS (r = −0.45, p < 0.001), and GCS (r = −0.41, p = 0.005), respectively. No significant correlation was found between the ratio of early transmitral velocity to peak early diastolic mitral annulus velocity (E/E′) and peak
$$ \dot{V}{\text{O}}_{2} $$
. In the patients with heart failure and reduced LVEF, a multiple stepwise linear regression analysis based on leg muscle strength, LVEF, E/E′, GLS, and GCS was performed to identify independent predictors of peak
$$ \dot{V}{\text{O}}_{2} $$
, resulting in leg muscle strength and GLS (R
2 = 0.888) as independent predictors of peak
$$ \dot{V}{\text{O}}_{2} $$
. Global longitudinal strain at rest could possibly predict exercise capacity, which appeared to be more useful than LVEF, E/E′, and GCS in CHF patients with reduced LVEF.
Tài liệu tham khảo
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