Association between left ventricular global longitudinal strain and natriuretic peptides in outpatients with chronic systolic heart failure.
BACKGROUND
Both impaired left ventricular (LV) global longitudinal strain (GLS) and increased plasma concentrations of natriuretic peptides(NP) are associated with a poor outcome in heart failure (HF). Increased levels of NP reflect increased wall stress of the LV. However, little is known about the relationship between LV GLS and NP. This aim of this study was to evaluate the relationship between the echocardiographic measure LV GLS and plasma levels of NP.


METHODS
We prospectively included 149 patients with verified systolic HF at the baseline visit in an outpatient HF clinic. LV GLS was assessed by two dimension speckle tracking and plasma concentrations of N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) and pro-atrial-natriuretic-peptide (proANP) were analysed.


RESULTS
The patients had a median age of 70 years, 28.2 % were females, 26.5 % were in functional class III-IV, median left ventricular ejection fraction (LVEF) was 33 % and median LV GLS was -11 %. LV GLS was associated with increased plasma concentrations of NT-proBNP and proANP in multivariate logistic regression (NT-proBNP: Odds RatioGLS: 7.25, 95 %-CI: 2.48-21.1, P < 0.001 and proANP: Odds RatioGLS: 3.26, 95-%-CI: 1.28-8.30, P = 0.013) and linear regression (NT-proBNP: βGLS: 1.19, 95 %-CI: 0.62-1.76, P < 0.001 and proANP: βGLS: 0.42, 95-%-CI: 0.11-0.72, P = 0.007) models after adjustment for traditional confounders (age, gender, body-mass-index, atrial fibrillation, renal function) and left atrial volume index.


CONCLUSIONS
Impaired LV GLS is associated with increased plasma concentrations of NP and our data suggest that left ventricular myocardial mechanics estimated by LV GLS reflects myocardial wall stress in chronic systolic HF.
Department of Cardiology, Herlev University Hospital, DK-2730, Herlev, Denmark. freja.stoltze.gaborit@regionh.dk.
F
F
Gaborit
Department of Internal Medicine KNEA, North Zealand University Hospital, DK-3400, Hillerod, Denmark.
H
H
Bosselmann
Department of Internal Medicine KNEA, North Zealand University Hospital, DK-3400, Hillerod, Denmark.
N
N
Tønder
Department of Cardiology, Herlev University Hospital, DK-2730, Herlev, Denmark.
K
K
Iversen
Department of Cardiology, Herlev University Hospital, DK-2730, Herlev, Denmark.
T
T
Kümler
Department of Internal Medicine O, Herlev University Hospital, DK-2730, Herlev, Denmark.
C
C
Kistorp
Department of Clinical Biochemistry, North Zealand University Hospital, DK-3400, Hillerod, Denmark.
G
G
Sölétormos
Department of Clinical Biochemistry, Rigshospitalet, DK-2100, Copenhagen, Denmark.
J P
JP
Goetze
Department of Cardiology, Herlev University Hospital, DK-2730, Herlev, Denmark.
M
M
Schou
D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D002908:Chronic Disease; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D045265:Natriuretic Peptides / Q000097:blood*; D011446:Prospective Studies; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology
D045265:Natriuretic Peptides