Sol Ventrikül Diyastolik Disfonksiyonunu Belirlemede 3D strain Ekokardiyografi

Abstract

3D Strain Echocardiography In Assessing Left Ventricular Diastolic Dysfunction; Hacettepe University, Faculty of Medicine, Cardiology Thesis. Ankara, 2018. Diastolic dysfunction is an important factor in the development of heart failure with preserved ejection fraction (HFpEF). Strain-rate imaging and 3D strain echocardiography provide important data for the evaluation of myocardial dysfunction. As the ejection fraction is preserved in HFpEF, the diagnosis of this disease with non-invasive methods is difficult. In this study, the relationship of BNP, NT-proBNP, Ghrelin, and echocardiographic 3D strain findings with diastolic dysfunction was investigated in patients undergoing left heart catheterization. Our study is a cross-sectional study and included 78 patients in whom echocardiography was performed, and who underwent left heart catheterization based on relevant indications. The patient data recorded for evaluation included the findings from left heart catheterization, follow-up 3D echocardiography; and the levels of blood NT-proBNP, and Ghrelin. The rate of diastolic dysfunction was 42.3%. Demographic features were not significantly different between the groups of patients with and without diastolic dysfunction. Longitudinal 2D and 3D mean strain as absolute values were observed to decrease more in patients with diastolic dysfunction. The median levels of BNP, NT-proBNP, and Ghrelin levels were higher in patients with diastolic dysfunction. The independent predictors of diastolic dysfunction were determined to be the left atrial volume index (LAVI) (OR = 1.17; p=0.018), longitudinal 3D strain values (OR=1.88; p < 0.001), NT-proBNP (OR=1.11; p=0.001), and Ghrelin (OR=1.40; p=0.001), respectively. There was a positive correlation between the diastolic dysfunction parameters and echocardiographic 2D and 3D strain values; and with the biomarker levels, which are BNP, NT-proBNP, and Ghrelin levels. In conclusion, our study found out that the reduced 3D strain absolute values and increased levels of NT-proBNP and Ghrelin biomarkers predicted diastolic dysfunction. If further large-scale studies prove the efficiency of these practical, they may not only allow for making a diagnosis of HFpEF more readily but may also eliminate the confusion in diagnostic algorithms.