Abstract 14136: Right Ventricle Speckle Tracking Analysis During Maximal Exercise in Heart Failure Patients: Possible Indicator of Impaired Ventilatory Efficiency Rather Than Overall Exercise Performance?
Background: Speckle tracking (ST) analysis is a reliable methodology that allow to quantify myocardial functional properties better than traditional echo parameters.
Purpose: We considered a heart failure reduced ejection fraction (HFrEF) population with the aim to investigate how a 2D ST analysis on right ventricle at peak exercise could help to stratify different cardiopulmonary exercise testing (CPET) functional phenotypes.
Methods: 36 HFrEF patients (mean age 69±12; male 69%; NYHA I-II-III-IV 19-17-25-5 %) underwent a maximal CPET evaluation combined with Echo-Doppler and off-line ST analysis. Study population was divided in two groups according to median value of 2D right ventricle longitudinal strain at peak exercise (Group A RVLG at peak < -16 vs Group B ≥ -16). In all patients we performed rest and peak 2D left atrium (LA LG), left and right ventricle longitudinal (LV LG, RV LG) strain, considering RV free-wall LG strain and RV LG global strain.
Results: The table reports main echo and CPET results in the two groups of patients. Despite similar left ventricle function and RVLG at rest, Group B showed nonsignificant differences in exercise performance (peak VO2) but more impaired ventilation (increased VE/VCO2 slope and reduced PetCO2), associated with more advanced RV reserve limitation and lower LA LG strain at peak exercise.
Conclusions: In HFrEF patients, a worse RV disease negatively influence the exercise gas exchange phenotype and RV strain analysis performed at peak exercise is of additive value in the identification of patients with impaired ventilatory efficiency.
Author Disclosures: V. Donghi: None. F. Carbone: None. V. Labate: None. G. Generati: None. M. Pellegrino: None. F. Bandera: None. E. Alfonzetti: None. M. Guazzi: None.
- © 2015 by American Heart Association, Inc.