Biventricular longitudinal strain as a predictor of functional improvement after D-shant device implantation in patients with heart failure

Yi Zhou; Yi Zhou; Yi Zhou; He Li; He Li; He Li; Lingyun Fang; Lingyun Fang; Lingyun Fang; Wenqian Wu; Wenqian Wu; Wenqian Wu; Zhenxing Sun; Zhenxing Sun; Zhenxing Sun; Ziming Zhang; Ziming Zhang; Ziming Zhang; Manwei Liu; Manwei Liu; Manwei Liu; Jie Liu; Jie Liu; Jie Liu; Lin He; Lin He; Lin He; Yihan Chen; Yihan Chen; Yihan Chen; Yuji Xie; Yuji Xie; Yuji Xie; Yuman Li; Yuman Li; Yuman Li; Mingxing Xie; Mingxing Xie; Mingxing Xie

doi:10.3389/fcvm.2023.1121689

Frontiers in Cardiovascular Medicine (Apr 2023)

Biventricular longitudinal strain as a predictor of functional improvement after D-shant device implantation in patients with heart failure

Yi Zhou,
Yi Zhou,
Yi Zhou,
He Li,
He Li,
He Li,
Lingyun Fang,
Lingyun Fang,
Lingyun Fang,
Wenqian Wu,
Wenqian Wu,
Wenqian Wu,
Zhenxing Sun,
Zhenxing Sun,
Zhenxing Sun,
Ziming Zhang,
Ziming Zhang,
Ziming Zhang,
Manwei Liu,
Manwei Liu,
Manwei Liu,
Jie Liu,
Jie Liu,
Jie Liu,
Lin He,
Lin He,
Lin He,
Yihan Chen,
Yihan Chen,
Yihan Chen,
Yuji Xie,
Yuji Xie,
Yuji Xie,
Yuman Li,
Yuman Li,
Yuman Li,
Mingxing Xie,
Mingxing Xie,
Mingxing Xie

Affiliations

Yi Zhou: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Yi Zhou: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Yi Zhou: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
He Li: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
He Li: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
He Li: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Lingyun Fang: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Lingyun Fang: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Lingyun Fang: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Wenqian Wu: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Wenqian Wu: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Wenqian Wu: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Zhenxing Sun: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Zhenxing Sun: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Zhenxing Sun: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Ziming Zhang: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Ziming Zhang: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Ziming Zhang: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Manwei Liu: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Manwei Liu: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Manwei Liu: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Jie Liu: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Jie Liu: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Jie Liu: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Lin He: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Lin He: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Lin He: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Yihan Chen: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Yihan Chen: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Yihan Chen: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Yuji Xie: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Yuji Xie: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Yuji Xie: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Yuman Li: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Yuman Li: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Yuman Li: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
Mingxing Xie: Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Mingxing Xie: Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China
Mingxing Xie: Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China

DOI: https://doi.org/10.3389/fcvm.2023.1121689
Journal volume & issue: Vol. 10

Abstract

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BackgroundThe creation of an atrial shunt is a novel approach for the management of heart failure (HF), and there is a need for advanced methods for detection of cardiac function response to an interatrial shunt device. Ventricular longitudinal strain is a more sensitive marker of cardiac function than conventional echocardiographic parameters, but data on the value of longitudinal strain as a predictor of improvement in cardiac function after implantation of an interatrial shunt device are scarce. We aimed to investigate the exploratory efficacy of the D-Shant device for interatrial shunting in treating heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), and to explore the predictive value of biventricular longitudinal strain for functional improvement in such patients.MethodsA total of 34 patients were enrolled (25 with HFrEF and 9 with HFpEF). All patients underwent conventional echocardiography and two-dimensional speckle tracking echocardiogram (2D-STE) at baseline and 6 months after implantation of a D-Shant device (WeiKe Medical Inc., WuHan, CN). Left ventricular global longitudinal strain (LVGLS) and right ventricular free wall longitudinal strain (RVFWLS) were evaluated by 2D-STE.ResultsThe D-Shant device was successfully implanted in all cases without periprocedural mortality. At 6-month follow-up, an improvement in New York Heart Association (NYHA) functional class was observed in 20 of 28 patients with HF. Compared with baseline, patients with HFrEF showed significant reduced left atrial volume index (LAVI) and increased right atrial (RA) dimensions, as well as improved LVGLS and RVFWLS, at 6-month follow-up. Despite reduction in LAVI and increase in RA dimensions, improvements in biventricular longitudinal strain did not occur in HFpEF patients. Multivariate logistic regression demonstrated that LVGLS [odds ratio (OR): 5.930; 95% CI: 1.463–24.038; P = 0.013] and RVFWLS (OR: 4.852; 95% CI: 1.372–17.159; P = 0.014) were predictive of improvement in NYHA functional class after D-Shant device implantation.ConclusionImprovements in clinical and functional status are observed in patients with HF 6 months after implantation of a D-Shant device. Preoperative biventricular longitudinal strain is predictive of improvement in NYHA functional class and may be helpful to identify patients who will experience better outcomes following implantation of an interatrial shunt device.

Published in Frontiers in Cardiovascular Medicine

ISSN: 2297-055X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.frontiersin.org/journals/cardiovascular-medicine

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