Impaired left ventricular global longitudinal strain in patients with heart failure with preserved ejection fraction: insights from the RELAX trial.

摘要: BACKGROUND While abnormal left ventricular (LV) global longitudinal strain (GLS) has been described in patients with heart failure preserved ejection fraction (HFpEF), its prevalence and clinical significance are poorly understood. METHODS AND RESULTS Patients enrolled the RELAX trial of sildenafil HFpEF (LV ≥50%) whom two-dimensional, speckle-tracking LV GLS was possible (n = 187) were analysed. The distribution associations characteristics, structure function, biomarkers, exercise capacity quality life assessed. Baseline median -14.6% (25th 75th percentile, -17.0% -11.9%, respectively) (≥ - 16%) 122/187 (65%) patients. tertile best had lower N-terminal pro-brain natriuretic peptide (NT-proBNP) [median 505 pg/mL (161, 1065) vs. 875 pg/mL (488, 1802), P = 0.008) collagen III propeptide (PIIINP) levels 6.7 µg/L (5.1, 8.1) 8.1 µg/L (6.5, 10.5), P = 0.001] compared worst GLS. There also a modest linear relationship log-transformed NT-proBNP PIIINP (r = 0.29, P < 0.001 r = 0.19, P = 0.009, respectively). We observed no association Minnesota Living Heart Failure scores, 6-min walk distance, peak oxygen consumption, or expiratory minute ventilation/carbon dioxide excretion slope. CONCLUSIONS Impaired is common among patients, indicating presence covert systolic dysfunction despite normal fraction. associated biomarkers wall stress synthesis diastolic but not capacity, suggesting other processes may be more responsible for these aspects syndrome.