Körperliche Belastbarkeit und systolische und diastolische Funktion bei Patient*innen mit asymptomatischer systolischer Herzinsuffizienz mit reduzierter linksventrikulärer Ejektionsfraktion

by Moritz Carlo Peters
Doctoral thesis
Date of Examination:2024-11-07
Date of issue:2024-11-06
Advisor:Dr. Anja PD. Sandek
Referee:Dr. Anja PD. Sandek
Referee:Prof. Dr. Christoph Herrmann-Lingen
Persistent Address: http://dx.doi.org/10.53846/goediss-10836

 

 

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Abstract

English

This dissertation took a closer look at 213 NYHA I patients with a reduced ejection fraction from the prospective-cohort study TransitionCHF-DZHK2 in Göttingen. Patients received a detailed echocardiographic examination and underwent spiroergometry to diagnose maximal exercise capacity. All participants were examined for combined diastolic dysfunction according to the HFA-PEFF score. In addition, echocardiographic parameters, such as the Global Longitudinal Strain (GLS), were compared with maximal exercise capacity (peakVO2). In summary, this study emphasizes the importance of diastolic dysfunction in addition to systolic dysfunction in NYHA I patients with HFrEF. Confirmed diastolic dysfunction appears to be present in at least half of all participants according to the HFA-PEFF score. Markers of diastolic dysfunction, such as GLS, appear to correlate better with exercise capacity than left ventricular ejection fraction. It is important to note that GLS, which assesses systolic and diastolic function, was the parameter that most accurately predicted peakVO2 in multivariate regression analyses. Further analyses, including the 5-year follow-up examination of TransitionCHF, are needed to establish a possible relationship between GLS, peakVO2 and the transition from NYHA class I to higher stages.
Keywords: heart failure; diastolic dysfunction; HFrEF; Exercise capacity; NYHA I; GLS