Results
Overall, there were 50 patients with a mean EF of 28.8 ± 6.0% who were included in the study. There were 37 (74%) patients with ischemic etiology and 41 (82%) patients were male. The mean LASr was 14.47 ± 6.19% and 70% of patients had grade 2 or 3 LVDD. The mean E/Em average ratio was 19.58 ± 8.22 and the median NT-pro-BNP level was 1312.5 pg/mL (Tables 1 and 2).
The LA strain parameters were correlated with the parameters assessing the RV systolic function and sPAP. The strong correlation of PVR with LA strain parameters was remarkable (Table 3).
As expected, the markers of increased LV filling pressure, the maximal LAVI, E/Em average, sPAP, and the NT-pro-BNP levels were higher in LVDD grades 2 and 3 compared to grade 1. Along with the increasing LVDD grades, the PVR showed an increasing trend and the echocardiograph RV systolic function parameters showed a decreasing trend.
The all patients with Grade 3 LVDD were male and NYHA class III patients were predominant in Grades 2 and 3 LVDD. The NT-pro-BNP levels were greater in Grade 2 and 3 LVDD patients compared to patients with grade 1 LVDD. All of the Grade 3 patients were using loop diuretics at various doses, and the other medications among groups were not different (Table 1).
All of the LA strain parameters and the conventional LA function parameters showed a decreasing trend along with the increased LVDD grades. The LAPEF and the LAScd in Grade 2 diastolic dysfunction were not different compared to the Grade 3 diastolic dysfunction. However, the LASct were lower in Grade 3 compared with the Grade 2 diastolic dysfunction (Table 2).