Echocardiographic data
The 2D echocardiographic characteristics are summarised in Table 2. Mean LVEF in the study group was 28±7%. There were no significant differences in LVEF across different categories of HF symptoms (p=0.06). However, LV GLS was significantly more impaired in severely symptomatic patients (-6.7%±2.8%) than in asymptomatic (-9.8%±3.2%) and mildly symptomatic patients (-8.3%±2.6%, p=0.002). Patients with severe symptoms also had higher E/A ratio and higher E/E’ ratio, reflecting a more impaired LV diastolic function. There were no significant differences in PASP across different NYHA classes (p=0.29).
Both TAPSE and S wave velocity were significantly lower in patients with severe HF symptoms (p=0.002 for both). Mean GLS-RV in the study group was -12±5%, while mean RVFW-LS was -15±7.9%. Both GLS-RV and RVFW-LS were significantly more impaired in severely symptomatic patients (p=0.01 and p=0.03, respectively) and they showed an excellent positive correlation with each other (r=0.87, p=<0.001).
3D echocardiographic data are summarized in Table 3. 3D LVEF was positively correlated with 2D LVEF (r=0.90, p<0.001) and negatively correlated to GLS-LV (r=-0.64, p<0.001). Mean 3D RVEF in the study group was 42±9% and it was significantly lower in patients with severe HF symptoms. RVEF was negatively correlated with GLS-RV (r=-0.51, p<0.001) and RVFW-LS (r=-0.47, p<0.001). The mean RVPAC was 0.77±0.30 and it differed significantly across different NYHA classes, being lowest in patients with severe symptoms of HF (Figure 2). RVPAC was positively correlated with TAPSE (r=0.37, p<0.001), S wave velocity (r=0.28, p=0.004), RV-FAC (r=0.25, p=0.01), RVEF (r=0.97, p<0.001) and negatively correlated with GLS-RV (r=-0.48, p<0.001) and RVFW-LS (r=-0.43, p<0.001). No correlation was found between RVPAC and either PASP (p=0.50), tricuspid E/A ratio (p=0.46) or tricuspid E/E’ ratio (p=0.13).