Suwijn J.Y. (Janne) (2019) Strain as a predictor for improvement of ejection fraction within new-onset heart failure patients. thesis, Medicine.
Full text available on request.Abstract
Background New-onset heart failure patients with an improved left ventricular ejection fraction (LVEF) have a better prognosis in contrast with patients that are not able to improve. However, there is no tool to predict improvement of LVEF. We hypothesized that clinical characteristics and thereby, focusing on echocardiographic left ventricular (LV) and left atrial (LA)-strain parameters can predict improvement of LVEF. Methods Retrospectively 314 new-onset heart failure patients were selected, who underwent evidence based medical treatment. Change in LVEF (ΔLVEF) between baseline (diagnosis <3 months) and follow-up (mean: 10 months) was determined. At baseline (diastolic and systolic) ventricular- and atrial strain and strain rate, were examined. Patients were divided in improved, stable and decreased LVEF groups. Additionally, analyses were performed with ΔLVEF as continuous variable. Results 167 (53%) patients had an improved LVEF, 36 (11%) had decreased LVEF and 111 (36%) remained stable. There was a significant difference between ΔLVEF groups for all LV strain parameters, LA strain and LA systolic strain rate. Univariate correlation of all LV strain parameters (except early diastolic strain rate) and LA strain and systolic strain rate were found for ΔLVEF. In a multivariate model LV strain (0.404 [95% CI:-0.772;-0.037]), LV early diastolic strain (-0.959 [95% CI: -1.539;-0.379]) and LV systolic strain rate (-6.759 [95% CI:-12.759;-0.759]) were significantly correlated with ΔLVEF. Also a negative correlation of ΔLVEF for age, LVEF, history of ischemic heart disease and device therapy was shown. Use of loop diuretic was positively associated with ΔLVEF. Conclusions This study shows that better LV systolic and diastolic strain parameters at the time of diagnoses (combined with clinical characteristics) might be used to predict improvement of LVEF in new-onset heart failure patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Voors, Prof. Dr. A.A. and Daily supervisor: and Nauta, Drs. J.F. and Location: and University Medical Center Groningen and Department: Cardiology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/218 |
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