Objective To explore the relationship between left ventricular function and cerebral arterial hemodynamics in patients with heart failure with preserved ejection fraction (HFpEF). Methods Fifty patients diagnosed with HFpEF in our hospital (HFpEF group) and fifty healthy volunteers (control group) were enrolled. Conventional echocardiographic parameters of the two groups were collected. Automatic cardiac motion quantification (aCMQ) technology was applied to obtain left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LVGLS) and circumferential strain (LVGCS) of the two groups. Transcranial color-coded duplex sonography (TCCS) was used to obtain the blood flow parameters of the middle cerebral artery: peak systolic velocity (PSV), end-diastolic velocity (EDV), and pulsatility index (PI). The differences in parameters between the two groups were compared. Pearson correlation analysis was used to analyze the correlation between left ventricular function and blood flow parameters of the middle cerebral artery; Logistic regression analysis was used to analyze the influencing factors of HFpEF. Results There were significant differences in the interventricular septal end-diastolic thickness (IVSD), left ventricular posterior wall end-diastolic thickness (LVPWD), early diastolic peak velocity of mitral annulus (e'), the ratio of early diastolic peak velocity of mitral orifice to early diastolic peak velocity of mitral annulus (E/e') and LVGLS between HFpEF group and control group. E/e', IVSD and LVPWD in the HFpEF group were higher than those in the control group, e' and the absolute values of LVGLS were lower than those in the control group. The PI in HFpEF group was higher than that in control group. The PI level of middle cerebral artery in HFpEF group was negatively correlated with the absolute values of LVGLS level (r=-0.327, P<0.05), and positively correlated with E/e, level (r=0.281, P<0.05). Logistic regression analysis showed that systolic blood pressure, LVGLS and PI were independent risk factors for HFpEF, and e' was an independent protective factor. Conclusion In HFpEF patients, the left ventricular longitudinal systolic function is impaired, the pulsation and stiffness of the middle cerebral artery are increased. There is a correlation between the increased stiffness of the middle cerebral artery and the impaired myocardial function.
Key words
heart failure with preserved ejection fraction /
automatic cardiac motion quantification /
long axis strain /
middle cerebral artery
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