We cannot rule out the possibility of confounding by unmeasured variables. HFmrEF = 18, HFpEF = 17, controls: = 19). In controls, LV GLS remained stable in 36.8%, increased in 36.8% and decreased in 26.3% of subjects during HG. In HF subgroups, comparable patterns of LV GLS response were observed (HFpEF: stable 41.2%, increase 35.3%, decrease: 23.5%; HFmrEF: stable 50.0%, increase 16.7%, decrease: Arterolane 33.3%; HFrEF: stable 33.3%, increase 22.2%, decrease: 44.4%, = 0.668). Mean switch between LV GLS at rest and during HG ranged close to zero with broad standard deviation in all subgroups and was not significantly different between subgroups (+1.2 5.4%, ?0.6 8.3%, ?1.7 10.7%, and ?3.1 19.4%, = 0.746 in controls, HFpEF, HFmrEF and HFrEF, respectively). However, the absolute value of LV GLS changeirrespective of increase or decreasewas significantly different between subgroups with 4.4 3.2% in controls, 5.9 5.7% in HFpEF, 6.8 8.3% in HFmrEF and 14.1 13.3% in HFrEF (= 0.005). The complete value of LV GLS switch significantly correlated with resting LVEF, NTproBNP and Minnesota Living with Heart Failure questionnaire scores. Conclusion: The response to isometric exercise in LV GLS is usually heterogeneous in all HF subgroups and in controls. The absolute value of LV GLS switch during HG exercise is elevated in HF patients and associated with steps of HF severity. The diagnostic power of fast-SENC strain assessment in conjunction with HG appears to be limited. Trial Registration: URL: https://www.drks.de; Unique Identifier: DRKS00015615. (EMPATHY-HF) was an investigator-initiated, prospective, cross-sectional study (German Clinical Trials Register ID: DRKS00015615). The study was performed in compliance with the Declaration of Helsinki and the study protocol was approved by the local institutional review table (Ethikausschuss 4 am Campus Benjamin Franklin, Charit Universit?tsmedizin Berlin). All patients provided written informed consent before entering the study. A dedicated analysis of specific resting cMRI parameters derived from this study population has been published previously (19). We included patients with stable chronic HF. Inclusion criteria are described in detail elsewhere (20). In brief, dyspnea NYHA class II or more and NTproBNP 220 ng/l were required for all HF patients, while specific imaging requirements applied for HFpEF (LV EF 50%, E/e’ 13 or left Rabbit polyclonal to ZNF22 atrial volume index 34 mL/m2 or LV septum thickness 12 mm), HFmrEF (LV EF 40C49%) and HFrEF (LV EF 40%), as per European Society of Cardiology guidelines (2). All patients had to receive medical therapy as recommended in current guidelines. Additionally, we included controls without HF. Exclusion criteria included atrial fibrillation (AF), high-grade valvular disease or a history of valve replacement, and cMRI contraindications such as implanted cardioverter-defibrillator (ICD) or pacemaker, BMI 38 kg/m2 as well as a history of adverse contrast-medium reaction. Study Procedures All subjects underwent comprehensive clinical work-up including physical examination laboratory evaluation, ECG, 6-min Arterolane walk test and quality of life assessment using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Medical history, current diagnoses and medication were extracted from electronic health records. CMRI was performed using a clinical 1.5 Tesla MRI scanner (Achieva, Philips Healthcare, Best, The Netherlands) with a cardiac five-element phased array coil. Cine images were acquired using a retrospectively gated cine-cMRI in cardiac short-axis, vertical long-axis and horizontal long-axis orientations using a steady-state free precession sequence at rest. Fast-SENC was acquired at rest and during HG in real-time free breathing technique, as explained previously (14). In brief, this SENC method generates temporary markers within the myocardium based on the unique MRI properties of tissue. The deformation of the myocardium during the cardiac phases changes the density of the markers, which when captured using an MRI spiral acquisition produces a cine sequence of SENC images (Physique 1). Three short-axis planes (apical, mid, and basal level) as well as two-, three- and for-chamber planes were assessed. Open in a separate window Physique 1 Fast strain-encoded cardiac magnetic resonance imaging. (A) 62 year-old male with heart failure with reduced ejection portion; (B) 62 year-old male without heart disease; all subjects were at physical rest during image acquisition; all images were acquired at end-systole;.HFrEF patients were most likely to be men, had the Arterolane highest BMI the most smoking pack years on average. Table 1 Baseline characteristics. = 19= 17= 18= 18= 19= 17= 18= 18test of analysis of variance ( 0.05). controls. Methods: Patients with stable HF and controls were examined using cMRI at rest and during HG. Left ventricular (LV) global longitudinal strain (GLS) and global circumferential (GCS) were derived from image analysis software using fast-SENC. Strain switch -0.5 and +0.5 was classified as increase and decrease, respectively. Results: The study populace comprised 72 subjects, including HF with reduced, mid-range and preserved ejection portion and controls (HFrEF = 18 HFmrEF = 18, HFpEF = 17, controls: = 19). In controls, LV GLS remained stable in 36.8%, increased in 36.8% and decreased in 26.3% of subjects during HG. In HF subgroups, comparable patterns of LV GLS response were observed (HFpEF: stable 41.2%, increase 35.3%, decrease: 23.5%; HFmrEF: stable 50.0%, increase 16.7%, decrease: 33.3%; HFrEF: stable 33.3%, increase 22.2%, decrease: 44.4%, = 0.668). Mean switch between LV GLS at rest and during HG ranged close to zero with broad standard deviation in all subgroups and was not significantly different between subgroups (+1.2 5.4%, ?0.6 8.3%, ?1.7 10.7%, and ?3.1 19.4%, = 0.746 in controls, HFpEF, HFmrEF and HFrEF, respectively). However, the absolute value of LV GLS changeirrespective of increase or decreasewas significantly different between subgroups with 4.4 3.2% in controls, 5.9 5.7% in HFpEF, 6.8 8.3% in HFmrEF and 14.1 13.3% in HFrEF (= 0.005). The complete value of LV GLS switch significantly correlated with resting LVEF, NTproBNP and Minnesota Living with Heart Failure questionnaire scores. Conclusion: The response to isometric exercise in LV GLS is usually heterogeneous in all HF subgroups and in controls. The absolute value of LV GLS switch during HG exercise is elevated in HF patients and associated with steps of HF severity. The diagnostic power of fast-SENC strain assessment in conjunction with HG appears to be limited. Trial Registration: URL: https://www.drks.de; Unique Identifier: DRKS00015615. (EMPATHY-HF) was an investigator-initiated, prospective, cross-sectional study (German Clinical Trials Register ID: DRKS00015615). The study was performed in compliance with the Declaration of Helsinki and the study protocol was approved by the local institutional review table (Ethikausschuss 4 am Campus Benjamin Franklin, Charit Universit?tsmedizin Berlin). All patients provided written informed consent before entering the study. A dedicated analysis of specific resting cMRI parameters derived from this study population has been published previously (19). We included patients with stable chronic HF. Inclusion criteria are described in detail elsewhere (20). In brief, dyspnea NYHA class II or more and NTproBNP 220 ng/l were required for all HF patients, while specific imaging requirements applied for HFpEF (LV EF 50%, E/e’ 13 or left atrial volume index 34 mL/m2 or LV septum thickness 12 mm), HFmrEF (LV EF 40C49%) and HFrEF (LV EF 40%), as per European Society of Cardiology guidelines (2). All patients had to receive medical therapy as recommended in current guidelines. Additionally, we included controls without HF. Exclusion criteria included atrial fibrillation (AF), high-grade valvular disease or a brief history of valve alternative, and cMRI contraindications such as for example implanted cardioverter-defibrillator (ICD) or pacemaker, BMI 38 kg/m2 and a background of undesirable contrast-medium reaction. Research Procedures All topics underwent comprehensive medical work-up including physical exam lab evaluation, ECG, 6-min walk ensure that you standard of living evaluation using the Minnesota Coping with Center Failing Questionnaire (MLHFQ). Health background, current diagnoses and medicine had been extracted from digital health information. CMRI was performed utilizing a medical 1.5 Tesla MRI scanner (Achieva, Philips Healthcare, Best, HOLLAND) having a cardiac five-element phased array coil. Cine pictures had been acquired utilizing a retrospectively gated cine-cMRI in cardiac short-axis, vertical long-axis and horizontal long-axis orientations utilizing a steady-state free of charge precession series at rest. Fast-SENC was obtained at.
