Left ventricle ejection fraction and strain derived by  three-dimensional echocardiography are associated with exercise capacity in the patients with heart failure

Milena Pavlovic-Kleut; Aleksandra Sljivic; Vera Celic

doi:10.2298/VSP170716162P

Milena Pavlovic-Kleut University Clinical Hospital Center "Dr. Dragiša Mišović – Dedinje", Department of Cardiology, Belgrade, Serbia
Aleksandra Sljivic University Clinical Hospital Center "Dr. Dragiša Mišović – Dedinje", Department of Cardiology, Belgrade, Serbia
Vera Celic University Clinical Hospital Center "Dr. Dragiša Mišović – Dedinje", Department of Cardiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170716162P

Keywords: heart failure, myocardial contraction, echocardiography, ventricular function, left, exercise test, oxygen consumption

Abstract

Background/Aim. Echocardiography represents the most commonly performed noninvasive cardiac imaging tests for the patients with heart failure (HF). The aim of this study was to assess the relationship between the exercise capacity parameters [peak oxygen consumption (VO₂) and the minute ventilation-carbon dioxide production relationship (VE/VCO₂)] and the three-dimensional speckle-tracking echocardiography (3D-STE) imaging of left ventricular (LV) function in the HF patients with the reduced LV ejection fraction (LVEF). Methods. This cross-sectional study included 80 patients with diagnosed ischemic LV systolic dysfunction (LVEF < 45%) divided into subgroups based on the proposed values of analyzed cardiopulmonary exercise testing (CPET) variables: VO₂peak ≤ 15 mL/kg/min, VO₂peak > 15 mL/kg/min, VE/VCO₂slope < 36 and VE/VCO₂slope ≥ 36. All patients underwent a physical examination, laboratory testing, two-dimensional (2D) and 3DE, and CPET. Results. LVEF, global longitudinal, circumferential, radial and area strains were significantly lower in the subgroups of subjects with a peak VO₂less, or equal to 15 mL O₂/kg per min and with a VE/VCO₂slope greater, or equal to 36 compared to the subgroups of subjects with a peak VO₂greater than 15 mL O₂/kg per min and with a VE/VCO₂slope less than 36. There was a significantly positive correlation between the peak VO₂values and parameters of 3DE, and a significantly negative correlation between the VE/VCO₂slope values and parameters of 3DE. Conclusion. The results of this study provide further evidence that the LV function can be noninvasively and objectively measured by 3D-STE. A significant correlation between examined parameters suggests that LVEF and strain derived by 3DE are associated with exercise capacity in the patients with HF.

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