Early changes in left ventricular function reviewed by left atrioventricular global longitudinal strain in pa-tients with heart failure after treatment with recombinant human brain natriuretic peptide
Zhao Jianpeng
Zhao Zhongxin
Li Zhen
Abstract：Objective To investigate the early changes in left ventricular function reviewed by left atrioventricular global longitudinal strain(GLS)in patients with heart failure(HF)after treatment with recombinant human brain natriuretic peptide(rhBNP).Methods HF patients(n=106)were chosen and divided,according to therapies,into observation group(treated with rhBNP)and control group(treated with routine therapy,each n=53)in Department of Cardiology in the Sixth People's Hospital of Hengshui City of Hebei Province from Sept.2020 to Sept.2023.The clinical data,GLS and relative parameters of left heart function were compared between 2 groups.The relationship between GLS value and parameters of left heart function was analyzed by using multiple linear regression analysis.The independent influence factors of left heart function were analyzed by using multi-factor Logistic analysis.The impact of gender on relationship between GLS and left heart function was analyzed by using stratified interaction analysis.The dose-response relationship between GLS value and left heart function risk after rhBNP treatment was analyzed by using restricted cubic spline model.The predictive ability of various indexes to poor prognosis of left heart function was analyzed,and a predictive model was established by using y=1-1/(1+e-z)regression equation and was validated by using cross validation method.Results The levels of GLS,global peak systolic strain(GCS)of left ventricular axis and global systolic strain rate(GSR)were significantly lower in observation group than those in control group(P＜0.05).There were no significant differences in levels of left ventricular overall torsion(ROT),left ventricular overall torsion rate(ROTR),early diastolic strain rate(GSRe),and advanced diastolic strain rate(GSRa)between 2 groups(P＞0.05).GLS was significantly correlated to GCS and GSRs(all P＜0.001).The results of multi-factor Logistic analysis showed that gender(OR=6.254,95%CI:5.255～9.226,P=0.002),left ventricular ejection fraction(LVEF,OR=2.148,95%CI:1.297～4.268,P=0.038),GLS(OR=0.513,95%CI:0.486～0.864,P=0.019)and GCS(OR=0.642,95%CI:0.598～0.817,P=0.021)were independent influence factors for left heart function.The results of interaction test(P-interaction)showed that gender did not affect the relationship between GLS and left heart function,regardless of adjusting for other factors.When the GLS value was≥0,the risk of poor left heart function hardly changed with the increase of GLS value(HR=1.465,95%CI:1.244～1.743,P＜0.001).The overall adaptability of structural equation prediction model was good[before internal verification,AUC=0.846(95%CI:0.831～0.876,P＜0.05),after internal verification,AUC=0.868(95%CI:0.827～0.881,P＜0.05)],which reflected well the relationship between various influence factors and left heart function in HF patients after rhBNP treatment,and the predictive mode was relatively stable(Nagelkerke R2=0.798).Conclusion GLS can effectively review early changes of left heart function,and predictive ability to poor left heart function can be improved by GLS value combined with indexes of left heart function in HF patients treated with rhBNP.
Keywords：Left atrioventricular global longitudinal strainHeart failureRecombinant human brain natriuretic peptideEarly changes of left ventricular function
Publication Date：2025-01-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 88-93 )