Przewlocka-Kosmala, M and Marwick, TH and Mysiak, A and Kosowski, W and Kosmala, W, Usefulness of myocardial work measurement in the assessment of left ventricular systolic reserve response to spironolactone in heart failure with preserved ejection fraction, European Heart Journal - Cardiovascular Imaging pp. 1-9. ISSN 2047-2404 (2019) [Refereed Article]
Copyright 2019 The Authors
Methods and Results: We analysed 114 patients (67 ± 8 years) participating in the STRUCTURE study (57 randomized to spironolactone and 57 to placebo). Resting and immediately post-exercise echocardiograms were performed at baseline and at 6-month follow-up. The following indices of MW were assessed: global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. The amelioration of exercise intolerance at follow-up in the spironolactone group was accompanied by a significant improvement in exertional increase in GCW (P = 0.002) but not in GLS and other MW parameters. Increase in exercise capacity at 6 months was independently correlated with change in exertional increase in GCW from baseline to follow-up (β = 0.24; P = 0.009) but not with GLS (P = 0.14); however, no significant interaction with the use of spironolactone on peak VO2 was found (P = 0.97).
Conclusion: GCW as a measure of LV contractile response to exertion is a better determinant of exercise capacity in HFpEF than GLS. Improvement in functional capacity during follow-up is associated with improvement in exertional increment of GCW.
|Item Type:||Refereed Article|
|Keywords:||HFpEF, spironolactone, global longitudinal strain, myocardial work|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Cardiovascular System and Diseases|
|UTAS Author:||Marwick, TH (Professor Tom Marwick)|
|UTAS Author:||Kosmala, W (Professor Wojciech Kosmala)|
|Deposited By:||Menzies Institute for Medical Research|
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