Background

There is no definition for strain deformation values in relation to cardiorespiratory fitness (CRF) in different heart failure (HF) phenotypes.

Aim

To identify the relationship between echocardiographic systolic function measurements and CRF in HF patients.

Methods

Systematic review and meta-analysis following the PRISMA recommendations. Studies reporting echocardiographic assessments of left ventricular global longitudinal strain (LVGLS), left ventricular ejection fraction (LVEF) and direct measurement of peak oxygen uptake (VO_2peak) in HF patients with reduced or preserved LVEF (HFrEF, HFpEF) were included. The patients were divided into Weber classes according to VO_2peak.

Results

Twenty-five studies involving a total of 2,136 patients (70.5% with HFpEF) were included. Mean LVEF and LVGLS were similar in HFpEF patients in Weber Class A/B and Class C/D. In HFrEF patients, a non-significant difference was found in LVEF between Weber Class A/B (30.2% [95%CI: 29.6 to 30.9%]) and Class C/D (25.2% [95%CI: 20.5 to 29.9%]). In HFrEF patients, mean LVGLS was significantly lower in Class C/D compared to Class A/B (6.5% [95%CI: 6.0 to 7.1%] and 10.3% [95%CI: 9.0 to 11.5%], respectively). The correlation between VO_2peak and LVGLS (r² = 0.245) was nearly twofold stronger than that between VO_2peak and LVEF (r² = 0.137).

Conclusions

Low LVGLS values were associated with low CRF in HFrEF patients. Although a weak correlation was found between systolic function at rest and CRF, the correlation between VO_2peak and LVGLS was nearly twofold stronger than that with LVEF, indicating that LVGLS may be a better predictor of CRF in patients with HFrEF.

中文翻译：

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心力衰竭患者左心室整体纵向应变和心肺健康：系统评价和荟萃分析

背景

不同心力衰竭 (HF) 表型中与心肺健康 (CRF) 相关的应变变形值没有定义。

目的

旨在确定心力衰竭患者超声心动图收缩功能测量与 CRF 之间的关系。

方法

遵循 PRISMA 建议进行系统审查和荟萃分析。研究报告了左心室整体纵向应变 (LVGLS)、左心室射血分数 (LVEF) 的超声心动图评估以及 LVEF降低或保留的心力衰竭患者 (HFrEF、HFpEF)直接测量峰值摄氧量 (VO _{2peak ) 的研究。根据VO 2peak}将患者分为Weber 等级。

结果

纳入了 25 项研究，共涉及 2,136 名患者（70.5% 患有 HFpEF）。Weber A/B 级和 C/D 级 HFpEF 患者的平均 LVEF 和 LVGLS 相似。在 HFrEF 患者中，Weber A/B 级（30.2% [95%CI：29.6 至 30.9%]）和 C/D 级（25.2% [95%CI：20.5 至 29.9%]）之间的 LVEF 没有显着差异]）。在 HFrEF 患者中，C/D 类患者的平均 LVGLS 显着低于 A/B 类患者（分别为 6.5% [95%CI: 6.0 to 7.1%] 和 10.3% [95%CI: 9.0 to 11.5%]）。_{VO 2peak}和 LVGLS之间的相关性(r ² = 0.245) 几乎是 VO _2peak和 LVEF 之间的相关性 (r ² = 0.137) 的两倍。

结论

HFrEF 患者中低 LVGLS 值与低 CRF 相关。尽管静息收缩功能与 CRF 之间的相关性较弱，但 VO _2peak与 LVGLS 之间的相关性几乎是 LVEF 的两倍，表明 LVGLS 可能是 HFrEF 患者 CRF 的更好预测因子。