Značaj parametara dijastolnog stres-ehokardiografskog testa kod bolesnika sa srčanom insuficijencijom i očuvanom ejekcionom frakcijom
Докторанд
Simonović, DejanМентор
Deljanin-Ilić, MarinaЧланови комисије
Pavlović, MilanĆirić Zdravković, Snežana
Petrović, Dejan
Đorđević-Dikić, Ana
Метаподаци
Приказ свих података о дисертацијиСажетак
Objective: to determine the parameters of LV and LA VVI
echocardiography, B-lines score, BNP levels, HFA PEFF algorithm
score, in the group of patients with HFpEF and compare them with
values in healthy subjects; to analyze their changes during diastolic
SET, then in relation to CV death and to establish which of the
examined variables stand out as independent predictors of future
adverse CV events (cardiovascular death).
Methodology: 110 subjects constituted the clinical (HFpEF) group,
and 40 subjects the control group. All subjects underwent diastolic
SET. Echocardiographic examination and pulmonary ultrasound were
performed: 1) at the beginning of diastolic SET; 2) at SF >100-110
beats/min 3) at rest. All subjects were contacted by telephone at 3, 6,
9, and 12 months, and CV events (HF rehospitalizations, CV death)
were recorded.
Results: adding the change in BNP/LAVi during diastolic SET, HFA
PEFF score significantly contributes to the diagnosis of HFpEF
(sensitivity 60.9% and spec...ificity 95%) and the exclusion of HFpEF
diagnosis (sensitivity 95.5% and specificity 72.5%). Below the cut-off
values for peak GLS LK (-17.22%) and change in GLS LK during
diastolic SET (0.35%), there is a high diagnostic ability to predict CV
death. Below the cut-off value for LASr at rest (25.5%), peak LASr
(28.1%) and change in LASr during diastolic SET (3.7%) there is a
high diagnostic ability to predict CV death. Below the cut-off value
for peak LASct (13.4%) and change in LASct during diastolic SET
(0.3%) there is significant diagnostic ability to predict CV death.
Higher peak B-line score values, changes in B-line score during
diastolic SET, and peak B-line score ≥10 significantly predicted CV
death. Higher values of initial HFA PEFF score, after diastolic SET,
as well as after adding variables (BNP/LAVi) significantly predict
CV death.
Conclusion: the addition of BNP/LAVi changes during diastolic SET
increased the sensitivity of the HFA PEFF score for the diagnosis of
HFpEF. The peak values of GLS LK, LASr and LASct were singled
out as independent predictors of mortality.