Correlation of left ventricular global longitudinal strain by speckle-tracking echocardiography with invasive LV filling pressure

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Abstract Introduction The left ventricular (LV) systolic function can affect diastolic relaxation. The interaction of systolic and diastolic myocardial function resembles the mechanism of "coil compression and relaxation." This concept has gained significant attention in recent years, challenging the notion of "isolated diastolic dysfunction." Speckle tracking echocardiography (STE) is a sensitive and innovative method for evaluating global myocardial function beyond LVEF. This study examined the possible correlation between left ventricular longitudinal strain (GLS) and different LV filling pressures. Method Patients scheduled for diagnostic coronary angiography and left heart catheterization were included. The exclusion criteria were any degree of mitral stenosis, more than moderate mitral regurgitation or aortic stenosis, left bundle branch block, or atrial fibrillation. Measurements of LV end-diastolic pressure (LVEDP), LV min diastolic pressure (LVMDP), and LV pre-A diastolic pressure (LV pre-A) were taken via cardiac catheterization. On the same day, LV global longitudinal strain (LV GLS) was assessed using the EPIQ 7 Philips vendor. Results A total of seventy patients were studied (mean age: 50.24 ± 12.6 years; 60% male). The mean LVEF was 46.8% (SD:10.3), and the mean E/e’= 11.1 (SD:4.1). Pearson’s correlation coefficient showed a moderate negative relationship between LV GLS and LVEDP (R=-0.45, p<0.001), LVMDP (R=-0.44, p<0.001), and LV pre-A (R=-0.43, p<0.001). Conclusion The correlation of multiple invasive LV filling pressure parameters (LVEDP, LVMDP, and LV pre-A pressure) with LV GLS signifies the possible role of systolic parameters in predicting diastolic dysfunction. Integrating LV GLS with conventional algorithms may improve the non-invasive assessment of diastolic dysfunction.

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