In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EACVI Silver Members, Fellows of the ESC and Young combined Members

The relationship between longitudinal function and symptoms in patients with heart failure with reduced ejection fraction

Session Poster session 1

Speaker Marcus Carlsson

Congress : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance: Systolic and Diastolic Function
  • Session type : Poster Session
  • FP Number : P157

Authors : J Karlsson (Lund,SE), K Solem (Lund,SE), R Jablonowski (Lund,SE), F Seeman (Lund,SE), R Borgquist (Lund,SE), E Heiberg (Lund,SE), H Arheden (Lund,SE), M Carlsson (Lund,SE)

J Karlsson1 , K Solem2 , R Jablonowski1 , F Seeman1 , R Borgquist3 , E Heiberg1 , H Arheden1 , M Carlsson1 , 1Lund University, Department of Clinical Sciences Lund, Clinical Physiology - Lund - Sweden , 2Syntach AB - Lund - Sweden , 3Lund University, Department of Clinical Sciences Lund, Cardiology, Sweden - Lund - Sweden ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii112

Heart failure (HF) patients have poor prognosis and with an estimated 20 million patients worldwide, it is one of the most serious diseases affecting the world today. Research in this field is therefore important. The longitudinal shortening and lengthening, measured as atrioventricular plane displacement (AVPD) or mitral annular plane systolic excursion (MAPSE), have become recognized to infer additional prognostic information to ejection fraction (EF) and infarction using late gadolinium enhancement on cardiovascular magnetic resonance (CMR). New York Heart Association (NYHA) classification is a widely used tool for grading symptoms in patients with heart failure.

Although both NYHA class and AVPD have prognostic information, comparisons of AVPD with NYHA class are missing. Therefore, the aim of this study was to relate AVPD to NYHA class in patients with heart failure with reduced ejection fraction (HFrEF). We hypothesize that with increased NYHA class there is a concomitant decreased AVPD.

144 patients with congestive HF and an EF below 40% (62±12 years, 109 male) and 20 age-matched controls (62±11 years, 12 male) were imaged using CMR. Long-axis cine images (2ch, 3ch and 4ch) were acquired and analysed using a freely available software. Results are presented as mean ± SD and differences between NYHA classes are compared with ANOVA using post hoc analysis.

Subject characteristics are shown in Table 1. The mean AVPD for patients was 7.8±2.5mm and the mean NYHA classification was 2.8±0.8. There was a difference in AVPD between NYHA II (8.8±2.8 mm) and NYHA IV (6.6±1.8 mm, p=0.001, Figure 1A). AVPD for all NYHA classes were decreased compared to controls (p=<0.001). When normalizing AVPD with body surface area (BSA), there was a difference in NYHA I vs NYHA IV (p=0.03, Figure 1B) and NYHA II vs NYHA IV (p=0.006, Figure 1B). 

Left ventricular AVPD is reduced in all NYHA classes and there is a small stepwise decrease in AVPD with increasing NYHA class. Future research needs to investigate whether AVPD can add additional prognostic information compared to NYHA classification.

Patients [n] 20 144 7 42 66 29
SV [ml] 97 ± 20 70 ± 23 72 ± 21 77 ± 20 73 ± 24 53 ± 18
EF [%] 60 ± 5 27 ± 8 32 ± 4 29 ± 8 26 ± 8 24 ± 8
CI [l/min] 3.1 ± 0.5 2.4 ± 0.7 2.5 ± 0.5 2.6 ± 0.6 2.5 ± 0.7 2.2 ± 0.6
BSA [m2] 1.9 ± 0.2 2.0 ± 0.2 1.8 ± 0.2 2.0 ± 0.2 2.0 ± 0.2 1.9 ± 0.2

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are