Ventricular–arterial coupling and load-independent measures of left ventricular contractility in the subgroup of patients with heart failure and normal ejection fraction and controls
Control (n=60) | HFNEF (n=112) | |||
Without CAD (n=77) | With CAD (n=35) | Without versus with CAD | ||
Load-independent measures of contractility | ||||
PRSW (g/cm2) | 85±11 | 80±21*** | 74±24*** | NS |
cESS-corrected MWFS (%·cm2/kdyne·10−2) | 16.7±5.1 | 10.9±4.9*** | 9.9±4.8*** | NS |
mESS-corrected FS (%·cm2/kdyne·10−2) | 72.5±29.4 | 52.3±33.5** | 51.7±42.2** | NS |
Stress-corrected FS (% predicted from cESS) | 117±11 | 114±20 | 116±26 | NS |
Stress-corrected FS <80% of predicted (%) | 0 | 7 | 6 | NS |
Stress-corrected MWFS (% predicted from cESS) | 101±10 | 86±19*** | 83±20*** | NS |
Stress-corrected MWFS <78% of predicted (%) | 0 | 30*** | 42*** | NS |
Global two-dimensional strains | ||||
Circumferential strain (%) | 26.4±3.5 | 21.2±5.0*** | 20.0±4.5*** | NS |
Circumferential strain·EDV index (ml/m2) | 15.0±3.0 | 12.8±4.8* | 12.0±5.2** | NS |
cESS corrected-circumferential strain (%·cm2/kdyne·10−2) | 21.7±6.9 | 14.7±7.5*** | 12.9±5.1*** | NS |
Radial strain (%) | 44.5±10.2 | 32.8±11.5*** | 33.4±8.8*** | NS |
Radial strain·EDV index (ml/m2) | 24.8±7.0 | 20.5±9.4* | 20.2±10.3* | NS |
cESS corrected−radial strain (%·cm2/kdyne·10−2) | 36.0±12.6 | 23.0±15.1*** | 22.0±11.8*** | NS |
Longitudinal strain (%) | 20.9±2.5 | 16.3±3.7*** | 14.9±4.4*** | NS |
Longitudinal strain·EDV index (ml/m2) | 11.9±2.6 | 10.2±3.9* | 9.2±4.1** | NS |
cESS corrected-longitudinal strain (%·cm2/kdyne·10−2) | 16.9±4.2 | 11.0±4.7*** | 9.6±4.4*** | NS |
mESS corrected-longitudinal strain (%·cm2/kdyne·10−2) | 34.9±9.8 | 22.7±10.8*** | 20.2±10.5*** | NS |
Torsional strain (degree) | 21.6±5.2 | 16.1±7.5*** | 17.0±6.3*** | NS |
Torsional strain· (SV/EDV)(degree) | 14.6±3.8 | 10.0±4.9*** | 10.1±4.4*** | NS |
cESS corrected−torsional strain (degree·cm2/kdyne·10−2) | 17.6±5.9 | 11.2±6.7*** | 11.0±6.0*** | NS |
Comparisons were adjusted for age, sex, and body surface area when appropriate.
*p<0.05; **p<0.01; ***p<0.001 versus control.
CAD, coronary artery disease; cESS, circumferential end-systolic stress; EDV, end-diastolic volume; mESS, meridional end-systolic stress; FS, endocardial fractional shortening; HFNEF, heart failure with normal ejection fraction; MWFS, mid-wall fractional shortening; PRSW, pre-load recruitable stroke work; SV, stroke volume.