Correlation of Echocardiographic Parameters Including Myocardial Work Indices With Invasive Stroke Work Index in Advanced Heart Failure

BACKGROUND: This study aimed to analyze the correlations between echocardiographic parameters of left and right ventricular systolic function-including myocardial work indices-and invasively measured stroke work index (SWI) in patients with advanced heart failure being evaluated for heart transplantation. METHODS: Twenty-seven consecutive patients with advanced heart failure who were admitted to a tertiary heart hospital for left and right heart catheterization were included. Echocardiographic evaluations were performed on the same day, prior to catheterization. For the left ventricle (LV), the correlations of LV ejection fraction (LVEF) by Biplane Simpson method, LV global longitudinal strain (LV-GLS), LV global constructive work (LV-GCW), LV global work index (LV-GWI), LV global wasted work (LV-GWW), and LV global work efficiency (LV-GWE) with LV-SWI were assessed. For the right ventricle (RV), correlations of tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV-GCW, RV-GWI, RV-GWE, and RV-GWW with RV-SWI were analyzed. Correlations were evaluated using Spearman's correlation coefficient. RESULTS: LVEF and LV-GLS were significantly correlated with LV-SWI (r: 0.63, p < 0.001; r: -0.61, p < 0.001, respectively). Among all parameters, LV-GCW demonstrated the strongest correlation with LV-SWI, followed by LV-GWI (r: 0.71, p < 0.001; r: 0.69, p < 0.001, respectively). For the RV, RV-GWI and TAPSE showed moderate correlations with RV-SWI (r: 0.43, p: 0.02; r: 0.42, p: 0.02, respectively). Other RV parameters did not demonstrate significant correlations with RV-SWI. CONCLUSION: Among LV and RV systolic function parameters, myocardial work indices provide a more accurate estimation of ventricular systolic function than standard echocardiographic measures in patients with advanced heart failure.