Diastolic Strain Parameters and Their Role in Heart Failure Mortality

Importance of Diastolic Strain Parameters in Heart Failure

Heart failure (HF) has emerged as a significant public health concern, characterized by a high prevalence and mortality rate, particularly among the aging population. As the healthcare community seeks to improve clinical outcomes for patients with heart failure, understanding the prognostic value of diastolic strain parameters has become increasingly critical. Diastolic dysfunction is often a precursor to heart failure and is associated with poor outcomes. The measurement of diastolic strain parameters, particularly the E/e’ SR ratio, has been identified as a potential predictor of mortality and rehospitalization in advanced heart failure patients.

Recent studies indicate that diastolic strain parameters measured through echocardiography serve as reliable indicators of left ventricular filling pressures. The relationship between the early diastolic velocity of transmitral flow and the early diastolic strain rate (E/e’ SR) is particularly noteworthy. This measure has emerged as a key predictor of cardiovascular outcomes, allowing clinicians to identify patients at higher risk for adverse events (Tatar et al., 2023).

Furthermore, the use of speckle tracking echocardiography (STE) has revolutionized the assessment of myocardial deformation. By quantifying the strain rates, healthcare professionals can more accurately evaluate the heart’s diastolic function, leading to improved prognostic capabilities. In advanced heart failure, where patients often present with significant comorbidities, the ability to stratify risk effectively is crucial for optimizing management strategies and tailoring therapeutic interventions.

Association of E/e’ SR with Short-Term Mortality Rates

The E/e’ ratio, derived from echocardiographic measurements, has been shown to correlate strongly with left atrial pressure and overall heart failure severity. In a recent study involving 116 patients with advanced heart failure and reduced ejection fraction, higher E/e’ SR values were associated with increased short-term mortality (Tatar et al., 2023). Specifically, the study reported a 13.8% mortality rate within one month of follow-up, indicating that E/e’ SR could serve as a critical marker for predicting mortality in this patient cohort.

The statistical analysis indicated that serum NT-ProBNP levels and E/e’ SR were independent predictors of mortality, highlighting the significance of these parameters in clinical settings. The findings suggest that routine assessment of E/e’ SR could enhance risk stratification for patients with advanced heart failure, allowing for timely interventions that may improve survival outcomes.

Table 1: E/e’ SR and Mortality Predictors in Advanced Heart Failure

Predictors of Rehospitalization in Advanced Heart Failure Patients

Rehospitalization rates for heart failure remain alarmingly high, often necessitating the need for effective predictive strategies. In the same cohort study, 37.1% of patients were readmitted within a month, with the use of ACE inhibitors and apical 3C strain identified as independent predictors of rehospitalization (Tatar et al., 2023). This indicates that meticulous monitoring of these parameters may assist in preventing future hospital admissions.

The study’s findings underscore the importance of a comprehensive approach to managing heart failure patients, particularly in identifying those who may be at risk for worsening symptoms. The integration of diastolic strain parameters into routine clinical practice could facilitate better resource allocation and improve patient quality of life.

Table 2: Predictors of Rehospitalization in Heart Failure

Impact of Medication Use on Heart Failure Outcomes

Medication management plays a crucial role in the outcomes of heart failure patients. The study indicated that the administration of ACE inhibitors was linked to better outcomes, while the absence of these drugs was associated with an increased risk of mortality (Tatar et al., 2023). Additionally, the findings reflected the need for ongoing evaluation of medication adherence and the potential impact of polypharmacy on patient outcomes.

Effective medication management requires the integration of various healthcare professionals, including pharmacists, who can provide insights into optimizing pharmacotherapy. This collaborative approach ensures that patients receive personalized care tailored to their specific needs and helps mitigate the risks associated with medication-related problems.

The Role of Echocardiography in Managing Heart Failure

Echocardiography remains a cornerstone in the assessment and management of heart failure. Through advanced techniques such as STE, clinicians can derive valuable insights into myocardial function and diastolic properties that correlate with patient outcomes. The application of diastolic strain parameters, particularly E/e’ SR, enhances the ability to assess left ventricular filling pressures accurately.

The integration of echocardiographic findings into clinical practice allows for timely interventions and adjustments in treatment plans. This dynamic assessment can significantly impact patient management, particularly in those with advanced heart failure where timely recognition of worsening function is vital.

FAQ

What are diastolic strain parameters?

Diastolic strain parameters are echocardiographic measures that assess how well the heart relaxes and fills with blood during diastole. These measurements, particularly E/e’ SR, help in evaluating left ventricular filling pressures and overall heart function.

Why is E/e’ SR significant in heart failure?

E/e’ SR is significant because it serves as a reliable marker for predicting outcomes in heart failure patients. Elevated values are associated with higher mortality and rehospitalization rates, making it a valuable tool for risk stratification.

How does medication impact heart failure outcomes?

Medication, particularly ACE inhibitors, plays a critical role in managing heart failure outcomes. Proper medication management can improve prognosis and reduce the risk of adverse events, highlighting the importance of adherence and appropriate pharmacotherapy.

What is the role of echocardiography in heart failure management?

Echocardiography is essential in heart failure management as it provides insights into cardiac structure and function. Advanced techniques like STE allow clinicians to assess diastolic function and other parameters that correlate with clinical outcomes, facilitating timely interventions.

What should patients with heart failure discuss with their healthcare providers?

Patients with heart failure should discuss their medication regimen, potential side effects, and any changes in symptoms. Regular follow-ups and echocardiographic assessments can help in monitoring heart function and adjusting treatment strategies as needed.

References

1. Tatar, S., İcli, A., Arıbaş, A., Akilli, N. B., Sertdemir, A. L. (2023). Parâmetros de Strain Diastólico Estão Associados à Mortalidade em Curto Prazo e à Reinternação em Pacientes com Insuficiência Cardíaca Avançada. Retrieved from https://doi.org/10.36660/abc.20230670

2. Ul Haq, M. S., Dua, N., Patel, N., Khan, W., Alamgir, A., Yamin, S., Anwar, R., Zaidi, T. H., Khursheed, M. (2025). Exploring anxiety symptoms, coping strategies, and socio-demographic influences among myocardial infarction patients in a tertiary care setting. Retrieved from https://doi.org/10.1371/journal.pone.0323904

3. Sarvestan, J., Myrka, A., Wreyford, L., Lindholm, T., (2025). Identifying Medication Review Topics to Be Documented in a Structured Form in Electronic Health Record Systems: Delphi Consensus Survey. Retrieved from https://doi.org/10.2196/70133

4. Jeon, B., Kang, T., Choi, S. W. (2025). Lifestyle factors and health outcomes associated with infertility in women: A case-control study using National Health Insurance Database. Retrieved from https://doi.org/10.1186/s12978-025-02030-0

5. Magalhães, T. A., Carneiro, A. C. C., Moreira, V. M., Trad, H. S., Lopes, M. M. U., Cerci, R. J., Nacif, M. S. (2024). Diretriz de Tomografia Computadorizada e Ressonância Magnética Cardiovascular da Sociedade Brasileira de Cardiologia e do Colégio Brasileiro de Radiologia. Retrieved from https://doi.org/10.36660/abc.20240608