Department of Ultrasound, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China; Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
Int J Cardiol. 2024 Jan 1;394:131366. doi: 10.1016/j.ijcard.2023.131366. Epub 2023 Sep 20.
The ultrasound left ventricular pressure-strain loop (LV PSL) was applied to evaluate myocardial work in heart failure with improved ejection fraction (HFimpEF) versus patients with persistent heart failure with reduced ejection fraction (HFrEF) to investigate the value of myocardial work parameters in predicting HFimpEF.
We collected 120 patients with HFrEF and recorded clinical characteristics and echocardiographic parameters (PSL technique) of patients. Patients were divided into HFimpEF group or persistent HFrEF group according to the outcome of follow-up. Furthermore, differential clinical and echocardiographic parameters were determined by Student's t-test. We recognized the important echocardiographic parameters to predict whether patients would recover to HFimpEF using the univariate logistic regression analysis and ROC curves. In addition, the multivariate logistic regression models were constructed and evaluated using Delong test and decision curve analysis.
Firstly, the HFimpEF group had a higher prevalence of hypertension and higher systolic blood pressure (P-values <0.05). In terms of echocardiographic parameters, HFimpEF group also had higher LVEF, LV GLS, GCW, GWE, and GWI and lower LVEDD (P-values <0.01). In particular, LVEF, LVEDD, GLS, GWI, and GCW were robust predictors of the conversion of HFrEF patients to HFimpEF (AUC >0.70, P-values <0.05). Finally, we determined that the predictive Model 4 (LVEF, LVEDD, GLS, and GCW) had the optimal diagnostic power.
The model constructed by GCW with LVEF, LVEDD, and GLS has important predictive value for HFimpEF, which is an effective clinical decision-making tool for providing disease assessment.
超声左心室压力-应变环（LV PSL）被应用于评估射血分数改善的心力衰竭（HFimpEF）与持续射血分数降低的心力衰竭（HFrEF）患者的心肌做功，以研究心肌做功参数在预测 HFimpEF 中的价值。
我们收集了 120 例 HFrEF 患者，记录了患者的临床特征和超声心动图参数（PSL 技术）。根据随访结果，患者分为 HFimpEF 组或持续 HFrEF 组。此外，采用 Student's t 检验确定差异的临床和超声心动图参数。我们使用单变量逻辑回归分析和 ROC 曲线识别重要的超声心动图参数，以预测患者是否会恢复到 HFimpEF。此外，使用 Delong 检验和决策曲线分析构建和评估多变量逻辑回归模型。
首先，HFimpEF 组高血压和收缩压较高（P 值均<0.05）。在超声心动图参数方面，HFimpEF 组的 LVEF、LV GLS、GCW、GWE 和 GWI 较高，LVEDD 较低（P 值均<0.01）。特别是 LVEF、LVEDD、GLS、GWI 和 GCW 是 HFrEF 患者转为 HFimpEF 的有力预测因子（AUC>0.70，P 值均<0.05）。最后，我们确定预测模型 4（LVEF、LVEDD、GLS 和 GCW）具有最佳的诊断能力。
由 LVEF、LVEDD 和 GLS 构建的 GCW 模型对 HFimpEF 具有重要的预测价值，是提供疾病评估的有效临床决策工具。
