title: Systolic mitral annulus velocity is a sensitive index for changes in left ventricular systolic function during inotropic therapy in patients with acute heart failure.
abstract: BACKGROUND
  Echocardiography is recommended for assessment of left ventricular systolic function in patients with acute heart failure but few randomised trials have validated techniques like tissue Doppler (TDI) and speckle tracking (STE) in patients with acute heart failure following ST-elevation myocardial infarction.
  
  
  METHODS
  This was a substudy from the LEAF (LEvosimendan in Acute heart Failure following myocardial infarction) trial (NCT00324766 ), which randomised 61 patients developing acute heart failure, including cardiogenic shock, within 48 hours after ST-elevation myocardial infarction, double-blind to a 25-hour infusion of levosimendan or placebo. TDI-derived systolic mitral annulus velocity (S'), STE-derived global longitudinal strain (Sl) and strain rate (SRl) were measured at baseline, day 1, day 5 and after 42 days.
  
  
  RESULTS
  Datasets rejected for analyses were 2% (TDI) and 17% (STE). S' increased by 23% in the levosimendan group versus 8% in the placebo group from baseline to day 1 ( p= 0.011) and by 30% vs. 3% from baseline to day 5 ( p <0.0005). Significant, but less pronounced, improvements in global Sl( p = 0.025 and p = 0.032) and in global SRl( p = 0.046 and p = 0.001) in favour of levosimendan were also present.
  
  
  CONCLUSIONS
  S' by TDI and STE-derived Sland SRlwere sensitive indices for changes in left ventricular systolic function related to treatment with levosimendan. However, S' by TDI was more feasible and sensitive and might be preferred for assessment of changes in left ventricular systolic function in critically ill patients with acute heart failure receiving inotropic therapy.
authors.affiliation: 1 Department of Cardiology, Oslo University Hospital Ullevål, Norway.|2 Centre for Heart Failure Research, University of Oslo, Norway.|3 Faculty of Medicine, University of Oslo, Norway.
authors.forename: Trygve
authors.initials: T
authors.lastname: Husebye
authors.affiliation: 1 Department of Cardiology, Oslo University Hospital Ullevål, Norway.|2 Centre for Heart Failure Research, University of Oslo, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Eritsland
authors.affiliation: 1 Department of Cardiology, Oslo University Hospital Ullevål, Norway.|2 Centre for Heart Failure Research, University of Oslo, Norway.
authors.forename: Reidar
authors.initials: R
authors.lastname: Bjørnerheim
authors.affiliation: 1 Department of Cardiology, Oslo University Hospital Ullevål, Norway.|2 Centre for Heart Failure Research, University of Oslo, Norway.|4 Centre for Clinical Heart Research, Oslo University Hospital Ullevål, Norway.
authors.forename: Geir Ø
authors.initials: GØ
authors.lastname: Andersen
mesh_terms: D000208:Acute Disease; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology*; D002316:Cardiotonic Agents / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011724:Pyridazines / Q000008:administration & dosage*; D015203:Reproducibility of Results; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000503:physiopathology; D000077464:Simendan; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan
keywords: Systolic mitral annulus velocity; acute heart failure; global longitudinal strain; levosimendan; myocardial contractility