Role of global longitudinal strain in assessment of left ventricular systolic function in patients with heart failure with preserved ejection fraction.

OBJECTIVES: To detect systolic dysfunction in heart failure with preserved ejection fraction (HFpEF) patients by using global longitudinal strain (GLS).

METHODS: This study included 46 heart failure patients: 24 with heart failure with reduced ejection fraction (HFrEF) and 22 with heart failure with preserved ejection fraction (HFpEF), and 20 patients with similar risk factor but no symptoms or signs of heart failure, matched for age and sex, as controls. All patients were screened by echocardiography. The ejection fraction of left ventricle was measured using Simpson's method and the GLS of the left ventricle was measured by using two-dimensional speckle tracking.

RESULTS: Left ventricular ejection fraction (LVEF) was 61.90 ± 2.94% in the controls, 60.45 ± 7.4% in the HFpEF group ( p  = 0.421), and 32.75 ± 8.45% in the HFrEF group ( p  = 0.001). The value of left ventricle (LV) GLS (controls =  -19.74 ± 1.12%, HFpEF =  -15.03 ± 2.03%, HFrEF =  -10.72 ± 1.99%, p  = 0.0001) was significantly impaired in the HFpEF group despite normal LVEF.

CONCLUSION: There is significant left ventricular systolic impairment detected by GLS despite preserved LVEF.