THE MYOCARDIAL DEFORMATION AND DIASTOLIC FUNCTION OF THE LEFT VENTRICLE IN PATIENTS WITH HEART FAILURE WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION
Objective. To evaluate myocardial function in patients with chronic heart failure with preserved left ventricular ejection fraction (CHF-PEF) by speckle tracking echocardiography. Design and methods. We examined 56 patients aged from 50 to 69 years with verified CHF-PEF, NYHA (New York Heart Association) class I–IIa and stage A–C of the ABCD classification of the American College of Cardiology, and 15 healthy persons. CHF-PEF was associated with arterial hypertension and coronary artery disease. The results of 6-minute walk test, echocardiography and speckle-tracking echocardiography were analyzed. Results. The average left ventricular ejection fraction measured by Simpson's method was 61,7 ± 5,28 %. According to the 6-minute walk test the patients were divided as followed: 26,7 % — stage A, 48,2 % — stage B, 25,1 % — stage C. All patients with CHF-PEF had the diastolic dysfunction: in 48 patients abnormal relaxation pattern was found, and in 8 pseudonormal pattern was shown. Patients with CHF-PEF had reduced global longitudinal strain (GLS –16,6 ± 2,58 %) and GLS rate (GLSR –0,74 ± 0,12 s) of the left ventricle. Also they had reduced strain and strain rate in basal anteroseptal (–13,2 ± 3,24 % and –0,75 ± 0,03 s-1) and basal anterolateral (–14,16 ± 3,29 % and –0,83 ± 0,12 s-1) segments. Conclusions. Patients with CHF-PEF have abnormal relaxation pattern and pseudonormal pattern of the diastolic dysfunction. They also have reduced global and segmental strain and strain rate of the left ventricle.