P304Left ventricle synchrony and contractile function in heart failure patients with systolic dysfunction


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Abstract

Objective: Evaluate in heart failure patients due to left ventricle (LV) systolic dysfunction the relationship between LV longitudinal dyssynchrony and LV global function.Methods: 100 pts (60% M), age 72.5±10 years old regularly followed in a heart failure clinic, ejection fraction (EF) of the left ventricle (LV) 30.78±9.5%, cardiac output 4.25±1.59, Nt-ProBNP median 1337.0 pg/ml, LV end diastolic diameter 6.82±0.97 cm.). LV Dyssynchrony: SD of longitudinal time-peak systolic in 12 LV segments (LV-SD12). LV longitudinal global strain (GS) and strain rate (GSR), mitral (septal) TDI S, E and A waves, LVEF and left atrium EF (LAEF) evaluated. Relationship between parameters evaluated with Pearson correlation coefficient and linear regression model (backward method). Dyssynchrony grouped accordingly to the quartiles (55.3, 79.4, 126.7).Results: LV dyssynchrony correlated with: (1) LV systolic function- LVEF (r= -0.30 =0.004), LV end diastolic dimension (r=0.337p=0.001), TDI Mt-S (r=-0.27 =0.014), LV-GS (r= 0.494 p<0.001), LS-GSRs (R= 0.504 p<0.001). (2) Diastolic function: TDI Mt-A (r= -0.246 p=0.05), TDI Mt-E (r= -0.264 p=0.010), GSRe (r=-0.425 p<0.001) and GSRa (r=-0.263 p<0.001). (3) By multiregression dyssynchrony was independently associated with GSRs (p=0.011) and GSRe (p=0.076).Conclusion: LV Dyssynchrony in HF patients is associated with longitudinal contractile function impairment, which reinforces the need for cardiac resynchronization therapy.

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