Results
Demographic and clinical characteristics: The study groups
included 27 patients with echocardiographically NDFx, 21 patients with
DDFx and 19 patients with IndtDFx who met the inclusion/exclusion
criteria and had strain (using speckle tracking echocardiography )
analyzable echo studies. The quality of 23 studies was insufficient for
strain-analysis, mostly due to low frame rates.
Clinical characteristics are demonstrated in table 1. Patients with DDFx
were nearly 2 decades older compared to patients with NDFx (69±11 vs.
50±15 years, p<0.05, respectively). Their body mass index was
higher, and they were 5 time more likely to be referred for
echocardiography for the evaluation of HF symptoms. Parameters included
in the metabolic syndrome (diabetes, hyperlipidemia, hypertension) were
also significantly more common in patients with DDFx. Patients with
IndtDFx showed the same pattern of differences as patients with DDFx
compared to patients with NDFx, showing an “in-between” pattern
regarding HF symptoms and diabetes mellitus. Age, body mass index,
hypertension and hyperlipidemia rates among patients IndtDFx were nearly
identical to patients with DDFx..
Echocardiographic findings: LV dimensions and systolic function
were similar and within the normal range in the 3 groups (table 2). Left
ventricular mass indexed for body surface area was abnormal and
significantly larger in patients with DDFx and IndtDFx compared to NDFx
(114±16, 110±25 vs. 94±16 gr/m2, respectively,
p<0.05 both compared to NDFx). LV global longitudinal strain
was found to be reduced among DDFx patients compared to NDFx and IndtDFx
patients.
As expected from the group allocation process, the parameters E’, E/E’ ,
pulmonary pressure, and LA volume index were abnormal and significantly
different in the DDFx compared to NDFx group. IndtDFx demonstrated
intermediate parameter abnormalities; overlapping with DDFx but
significantly different regarding E/E’. The parameters E’, E/E’ and LA
volume index in IndtDFx were significantly different compared to NDFx.,
Pulmonary pressure estimation followed the same pattern between groups,
but the difference was statistically significant between DDFx vs. NDFx.