Table 2:
Comparison of Clinical and Hemodynamic Indices
| Normal LV systolic function (n=244, 77%) | Occult LV systolic dysfunction (n=44, 14%) | Overt LV systolic dysfunction (n=27, 6%) | p | p* | |
|---|---|---|---|---|---|
| Echocardiography | |||||
| LVGLS, % | −24±2 | −16±2 | −15±3 | <0.001 | 0.1 |
| LVEF, % | 63±6 | 56±3 | 49±4 | <0.001 | 0.008 |
| LVEDV index, ml/m2 | 46±8 | 39±5 | 48±7 | <0.001 | <0.001 |
| LVESV index, ml/m2 | 17±6 | 16±5 | 25±5 | 0.2 | 0.003 |
| LV SV index, ml/m2 | 40±5 | 27±4 | 30±5 | <0.001 | 0.04 |
| Heart rate, bpm | 71±8 | 79±6 | 73±4 | 0.008 | 0.1 |
| LV CI, L/min/m2 | 2.9±0.6 | 2.1±0.4 | 2.3±0.4 | <0.001 | 0.08 |
| LV eccentricity index | 1.29±0.22 | 1.35±0.14 | 1.28±0.13 | 0.009 | 0.03 |
| RA reservoir strain, % | −31±7 | −23±6 | −28±5 | <0.001 | 0.02 |
| RVGLS, % | −19±4 | −16±3 | −18±3 | 0.03 | 0.09 |
| TAPSE, mm | 25±6 | 23±5 | 24±4 | 0.04 | 0.5 |
| RV s’, cm/s | 14±6 | 11±3 | 12±3 | 0.02 | 0.3 |
| RV end-diastolic area, cm2 | 46±12 | 57±10 | 59±9 | <0.001 | 0.3 |
| RV end-systolic area, cm2 | 28±7 | 42±9 | 39±10 | <0.001 | 0.2 |
| RV FAC, % | 39±7 | 26±7 | 33±8 | <0.001 | 0.002 |
| IVC collapsibility, % | 48±11 | 31±13 | 38±9 | 0.008 | 0.03 |
| † RA pressure, mmHg | 8±3 | 11±3 | 8±4 | 0.04 | 0.08 |
| TR velocity, m/s | 2.4±0.3 | 2.2±0.2 | 2.3±0.3 | 0.2 | 0.7 |
| Cardiac MRI (n=92) | (n=67) | (n=14) | (n=11) | ||
| RVEDV index, ml/m2 | 139 (106–171) | 163 (129–221) | 166 (134–198) | <0.001 | 0.3 |
| RVESV index, ml/m2 | 78 (57–114) | 97 (66–126) | 91 (66–126) | <0.001 | 0.1 |
| RV ejection fraction, % | 43±11 | 39±12 | 40±9 | 0.08 | 0.7 |
| LVEDV index, ml/m2 | 57±10 | 47±8 | 59±11 | <0.001 | <0.001 |
| LVESV index, ml/m2 | 15±5 | 22±6 | 27±8 | 0.03 | 0.09 |
| LVSV index, ml/m2 | 39±6 | 28±5 | 32±6 | <0.001 | 0.1 |
| LV ejection fraction, % | 64±8 | 58±6 | 45±5 | 0.07 | 0.004 |
| Clinical data | |||||
| Age, years | 37 (26–47) | 38 (29–49) | 39 (28–51) | 0.7 | 0.9 |
| Atrial septal defect | 160 (66%) | 32 (73%) | 10 (70%) | 0.4 | 0.9 |
| Systemic O2 saturation | 96±3 | 95±2 | 95±1 | 0.6 | 0.9 |
| Peak VO2, % | 69±7 [n=183] | 56±12 [n=36] | 61±11 [n=21] | <0.001 | 0.3 |
| GFR, ml/min/1.73m2 | 91±18 | 78±14 | 82±16 | 0.01 | 0.3 |
| NT-proBNP, pg/ml | 96 (51–216) | 181 (104–529) | 198 (94–616) | <0.001 | 0.8 |
| GDMT | 24 (10%) | 21 (48%) | 26 (96%) | <0.001 | <0.001 |
LVGLS: Left ventricular global longitudinal strain; LVEF: Left ventricular ejection fraction; LVEDV: Left ventricular end-diastolic volume; LVESV: Left ventricular end-systolic volume; LVSV: Left ventricular stroke volume: CI: Cardiac index; RVGLS: Right ventricular global longitudinal strain; RA; right atrium; TR: Tricuspid regurgitation; NT-proBNP: N-terminal pro-brain natriuretic peptide; GFR: Glomerular filtration rate; VO2: Oxygen consumption symmetry GDMT: Guideline directed medical therapy for heart failure. RVEF: Right ventricular ejection fraction; RVEDV: Right ventricular end-diastolic volume; RVESV: Right ventricular end-systolic volume; s’: annular tissue Doppler systolic velocity; IVC: Inferior vena cava; TAPSE: Tricuspid annular plane systolic excursion; MRI: Magnetic resonance imaging
RA pressure was based on inferior vena cava size and collapsibility
p value denotes comparison between Normal LV systolic function and Occult LV systolic dysfunction groups while p* denotes comparison between Occult LV systolic dysfunction and Overt LV systolic function groups