Vnitr Lek 2023, 69(8):494-498 | DOI: 10.36290/vnl.2023.099

Deformation parameters of left heart and serum levels of markers of endothelial dysfunction in patients with acute decompensation of chronic heart failure

Jakub Jurica¹, Ján Staško², Martin Jozef Péč¹, Ingrid Škorňová², Peter Galajda¹, Tomáš Bolek¹, Marek Cingel¹, Matej Samoš^{1, 3}, Marián Mokáň¹

¹ 1. interná klinika, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Martin

² Národné centrum hemostázy a trombózy, Klinika hematológie a transfuziológie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Martin

³ Oddelenie akútnej a intervenčnej kardiológie, 2. klinika kardiológie a angiológie, Stredoslovenský ústav srdcových a cievnych chorôb (SÚSCCH, a. s.) v Banskej Bystrici, Banská Bystrica

Aims: Two-dimensional speckle tracking (2D ST) analysis provides assessment of myocardial deformation and can be used as a diagnostic tool to determine the function of the left ventricle (LV) and the left atrium (LA). This study aimed to compare global longitudinal strain of LV (LV-GLS) and reservoir strain of LA (R-LAS) results between patients hospitalised for acute decompensation of heart failure (HF) and individuals with no known cardiovascular disease (CVD); and to observe the plasma concentration of vascular endothelial growth factor (VEGF) with treatment of acute decompensation of HF.

Methods: We performed a pilot, prospective and observational study involving 16 patients hospitalised for acute decompensation of HF. Each patient underwent transthoracic echocardiography (TTE) with 2D ST and the values of LV-GLS and R-LAS were obtained. The patients were divided into 2 subgroups according to the value of the left ventricular ejection fraction (EF) using a cut-off value of ≤ 40% to distinguish heart failure with preserved ejection fraction (HFpEF) - 10 patients, from heart failure with reduced ejection fraction (HFrEF) - 6 patients. Two samples of venous blood, one before and one after treatment, were also taken in each patient to be examined for the plasma concentration of VEGF. The control involved 16 persons without a history of CVD, each of whom underwent 2D ST analysis as well.

Results: We found that LV-GLS and R-LAS were significantly lower in both HFpEF and HFrEF subgroups in comparison with the control (LV-GLS: -13.4±4.7 % vs. -19.7±2.5 %, p < 0.05; R-LAS: +12.2±6.9 % vs. +40.3±7.4 %, p < 0.05). Furthermore, there was a significant difference in LV-GLS (-9.6±3.2 % vs. -15.2±4.3 %, p<0.05), but not in R-LAS (+13.7±8.6 % vs. +11.4±6.2 %) between HFrEF and HFpEF subgroups. The VEGF plasma concentrations after treatment were significantly greater in the HFpEF compared to the HFrEF group (213±161 pg/ml vs. 142±130 pg/ml, p<0.05).

Conclusion: Our study showed a significant difference in LV-GLS and R-LAS in all patients with HF compared to the control. There was also a significant difference in LV-GLS between the HFrEF and HFpEF subgroups. Ultimately, there was also a significant difference in the VEGF plasma concentrations after treatment between the subgroups.

Keywords: acute decompensation of chronic heart failure, global longitudinal strain, reservoir strain, vascular endothelial growth factor.

Accepted: November 27, 2023; Published: December 18, 2023  Show citation