Strain Echo in Acute Heart Failure

The purpose of this project is to evaluate the utility of left ventricular strain as part of
the assessment of patients in the emergency department with acute heart failure (HF). The
central hypothesis of the investigation is that left ventricular strain will prove to be a
treatment response variable in patients with acute HF. Patients who are being treated for
acute HF with intravenous (IV) vasoactive medications (diuretics, vasodilators, inotropes)
will be eligible for enrollment. Patients who give written consent will receive a focused
bedside echocardiogram within 30 minutes of the initiation of therapy for acute HF. Images
that are captured during this echocardiogram will be interpreted by a blinded cardiologist
offline. 23 hours after this initial focused echocardiogram a member of the study team will
perform a follow-up focused echocardiogram, capturing the same images that will then be
interpreted by a blinded cardiologist offline.

Offline analysis will be performed using a proprietary software package from General
Electric called Automated Function Imaging (AFI). The AFI software will be used to calculate
longitudinal strain of the left ventricle (LV). Regional and global strain values will be
calculated for each focused echocardiogram for each subject. It is our hypothesis that LV
strain will demonstrate improvements from the initial echocardiogram to the follow-up
echocardiogram, unlike other echocardiographic indices in HF such as LV ejection fraction.