Abstract 13480: Utility of Combined Assessment of Exercise Oscillatory Breathing and Global Circumferential Strain to Predict Cardiac Events in Heart Failure Patients
Background: The occurrence of cardiopulmonary exercise testing-derived exercise oscillatory breathing (EOB) is a predictor of survival in heart failure (HF) patients. Whereas, it was recently reported that global circumferential strain (GCS) as assessed by two-dimensional speckle-tracking imaging reflects intrinsic left ventricular (LV) myocardial function and is a powerful predictor of cardiovascular events, and thus appears to be a better predictive parameter than global LV function, including LV ejection fraction (EF). The objectives of our study were to test the hypothesis that a combined assessment of EOB and GCS can further enhance the ability of the method to predict cardiac events in HF patients.
Methods: A total of 86 HF patients with LVEF of 44±11% underwent cardiopulmonary exercise testing and echocardiography. GCS was determined as the peak global speckle-tracking strain from mid-LV short-axis view, and GCS of <10.7% was predefined as significant LV myocardial dysfunction for HF patients. EOB definition was based on the criteria as previously reported. Long-term unfavorable outcome events were pre-specified as primary end points of hospitalization for deteriorating HF over 2.0 years.
Results: Overall, patients with EOB (n=35) were associates with unfavorable clinical events compared with those without EOB (n=49) (2% vs. 18%, p=0.04). Of 35 patients with EOB, there were 10 patients with EOB and GCS10.7%. The prevalence of unfavorable clinical events of patients with EOB and GCS10.7% (70% vs. 4%, p<0.001).
Conclusions: The combined approach of EOB and GCS leads to more accurate prediction of unfavorable cardiac events than using individual parameters in HF patients. The study presented here offers new insights into management of HF patients.
Author Disclosures: H. Tanaka: None. Y. Tsuboi: None. K. Matsumoto: None. K. Dokuni: None. Y. Hatani: None. H. Matsuzoe: None. K. Hatazawa: None. H. Toki: None. H. Shimoura: None. J. Ooka: None. H. Sano: None. T. Sawa: None. Y. Motoji: None. Y. Mochizuki: None. K. Tatsumi: None. Y. Sakai: None. K. Hirata: None.
- © 2014 by American Heart Association, Inc.