Patients
Consecutive patients (ambulatory and hospitalized) referred to a transthoracic echocardiography study at our laboratory between 2014 and 2015 were retrospectively screened. Inclusion criteria were sinus rhythm and LVEF ≥45% at the time of screening.
Patients with ≥moderate left-sided valvular heart disease, acute coronary syndrome, chronic lung disease, pulmonary thrombo-embolic disease, and myocardial and pericardial diseases were ruled out. Subjects (n=1672) were divided into 3 groups based on the assessment of diastolic function: normal diastolic function (NDFx, n=1279); definite diastolic dysfunction (DDFx, n=237); and IndtDFx (n=156) according to the recent guidelines [6]. The parameters mitral E’, mitral E/E’ ratio , LA maximal volume index , and pulmonary pressure were used for the definition of each group [6]. NDFx was defined as less than 2 abnormal parameters, DDFx was defined as more than 2 abnormal parameters, and IndtDFx as 2 abnormal parameters.
We randomly selected 30 patients from each group for off-line strain and volumes analysis using speckle tracking echocardiography. Demographics , comorbidities, and HF symptoms (dyspnea, fatigue, weakness and/or reduced ability to exercise) were recorded.