Facteurs d'altération du strain global longitudinal ventriculaire gauche dans l'insuffisance cardiaque à fraction d'éjection ventriculaire gauche préservée

Introduction

In heart failure with preserved left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) has a diagnostic and prognostic value. This study aimed to identify the factors associated with the alteration of strain in heart failure with preserved left ventricular ejection fraction.

Methods

This study was carried out in patients with heart failure and preserved LVEF seen in the echocardiography laboratory of the DAX hospital center from 1^st January to 31^st October 2022. Patients with altered GLS < −16% (cases) were compared to controls (GLS ≥ −16 %) matched by age group and sex.

Result

During this period, 31 cases and 31 controls were recruited. The average age of the cases was 81.3 ± 11.8 years with a female predominance (51.6%). Alteration of left ventricular GLS was associated with history of coronary artery disease (OR 5.93, CI 95% [1.16–30.25], p = 0.04), very high cardiovascular risk (OR 19.6, CI 95% [1.90–201.63], p = 0,03), an interventricular septum thickness greater than 12 mm (OR 7, CI 95% [1.59–30.80], p = 0,00) and the presence of hypertrophic cardiomyopathy (p = 0.00).

Conclusion

GLS alteration was associated with history of coronary artery disease, very high cardiovascular risk, an interventricular septum thickness greater than 12 mm and hypertrophic cardiomyopathy. The knowledge of these factors could be interesting to improve the risk stratification and the management of heart failure with preserved LVEF.