Background: Impairment in left ventricular (LV) systolic function has been described in heart failure (HF) with preserved ejection fraction (HFpEF), but the prognostic of HFpEF according to de degree of LV-systolic dysfunction has been weakly evaluated. We sought to describe according to LV-longitudinal strain (LS), both the phenotype with and without LV-systolic dysfunction and to assess its prognostic value in the multicentric prospective cohort KaRen.

LS was assessed by 2-dimensional speckle-tracking echocardiography at baseline in 348 patients with HFpEF enrolled in KaRen (prospective international multicenter registry on HFpEF). At a median follow-up of 1.5 years (interquartile range, 0.8–2.7 years), 43% of the patients experienced the primary composite outcome of cardiovascular death, HF hospitalization. Impaired LS, defined as an absolute LS<16%, was present in 40.5% of patients but was not a predictor of the composite outcome. The phenotype with impaired LS was characterized by some key feature detailed Figure 1.

Main echocardiographic results are in Figure 1.

Impaired LV- systolic function is not systematic in HFpEF. The fact that LS is<16% is not associated with an increased risk of death or HF-hospitalisation. (Figure 1).