Left ventricular global longitudinal strain in secondary hypertension: A meta-analysis of echocardiographic studies

Abstract BACKGROUND Previous studies have shown that left ventricle global longitudinal strain (GLS) assessed with 2D-speckle tracking echocardiography, is an independent predictor of outcome in asymptomatic moderate to severe chronic aortic regurgitation (AR) patients. OBJECTIVES To assess GLS impact on mortality and need for aortic valve replacement (AVR) or symptom development in chronic asymptomatic AR patients and preserved left ventricular ejection fraction (LVEF). METHODS A literature search was performed according with these key terms "aortic regurgitation" and "longitudinal strain." The primary endpoint was all-cause mortality. Secondary end-points were: a composite of all-cause mortality, need for AVR or symptom development; and only AVR plus symptom development. Data was pooled using random-effects meta-analysis models. Pooled Hazard Ratio (HR) was performed using its log transformation and inverse variances as weights were then calculated for each study . RESULTS Six studies were included, with a total of 1,571 asymptomatic patients with at least moderate AR and preserved LVEF. There were 996 events (death, AVR, symptom development) reported during follow-up. Pooled adjusted mortality HR tended to be higher for patients with worse GLS (1.14 [0.96–1.35], P = 0.13, I2 51%). GLS performed better in predicting AVR or symptom development (mean difference -0.72 [-1.29, -0.15], P = 0.01, I2 88%), with an estimated HR of 1.36 ([1.01–1.84], P = 0.04, I2 65%). CONCLUSIONS In asymptomatic chronic moderate to severe AR patients, impaired GLS was associated with adverse cardiac outcomes. Left ventricular GLS may offer incremental value on risk stratification as well as on decision-making. Abstract P1391 Figure 1

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Derangements in Coronary Calcium Score and Left Ventricular Global Longitudinal Strain in Patients Post Left Breast Radiotherapy

10.21203/rs.2.24279/v1 ◽

2020 ◽

Author(s):

Tochi Okwuosa ◽

Andres Palomo ◽

Thelma Dangana ◽

Anel Yakupovich ◽

Sanjib Basu ◽

...

Keyword(s):

Breast Cancer ◽

Longitudinal Strain ◽

Meta Analysis ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Screening Methods ◽

Breast Radiotherapy ◽

Goodness Of Fit Test ◽

Significant Difference ◽

Historical Controls

Abstract Background Radiotherapy is a common treatment for breast cancer, with unintended long-term CV consequences; and no consensus on adequate CV screening methods to prevent future events. We aimed to assess the use of coronary artery calcium (CAC) and left ventricular global longitudinal strain (GLS) to identify those at risk for CVD due to radiotherapy. Methods Using data from an urban cancer registry, we enrolled 17 women (mean age 62 years) with left-sided breast cancer from 1999-2003, treated with radiotherapy. Agatston CAC score was measured by CT scan; and GLS by echocardiography. Logistic regression was used to compare study CAC scores with historical controls using age- and race-matched (Multi-Ethnic Study of Atherosclerosis) MESA CAC calculator [derived from MESA cohort from 6 US communities, free of clinical CVD at baseline (2000-2002) https://www.mesa-nhlbi.org ]; and GLS with historical controls from prior meta-analysis with defined normal GLS values ( Yingchoncharoen et al). Results The Hosmer-Lemeshow goodness of fit test reported a significant lack of fit (p < 0.02) compared with the expected probability of non-zero CAC in the historical controls from MESA. The mean GLS of -20.6% (95% CI: -21.50%, -19.79%), and was not statistically different when compared with the average of the historical controls. However, there was a significant difference of GLS compared to the meta-analysis using a one-sample T test with P=0.03. Conclusion We found that women post left sided breast radiotherapy had higher CAC presence without significant difference in mean GLS, compared with historical controls from the MESA database and prior GLS meta-analysis.

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Association of Global Longitudinal Strain with the Development of Adverse Left Ventricular Remodelling: A Systematic Review and Meta-Analysis

Heart Lung and Circulation ◽

10.1016/j.hlc.2019.06.246 ◽

2019 ◽

Vol 28 ◽

pp. S238

Author(s):

P. Thein ◽

M. Isa ◽

E. Wong ◽

A. Brown ◽

J. Cameron ◽

...

Keyword(s):

Systematic Review ◽

Longitudinal Strain ◽

Meta Analysis ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Ventricular Remodelling ◽

Left Ventricular Remodelling

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Prognostic Value of Left Ventricular Global Longitudinal Strain in Cardiac Amyloidosis - A Systematic Review and Meta-Analysis

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2020.09.102 ◽

2020 ◽

Vol 26 (10) ◽

pp. S33-S34

Author(s):

Ahmad Yehia Alazawie ◽

Ali S. Ali Al-Shammari ◽

Reham M. Ibrahim ◽

Mohammed T. Mutar ◽

Hilal Al-Saffar ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Value ◽

Cardiac Amyloidosis ◽

Longitudinal Strain ◽

Meta Analysis ◽

Global Longitudinal Strain ◽

Left Ventricular

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Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and meta-analysis

Journal of Intensive Care ◽

10.1186/s40560-020-00519-3 ◽

2021 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Arief Wibowo ◽

Raymond Pranata ◽

Astri Astuti ◽

Badai Bhatara Tiksnadi ◽

Erwan Martanto ◽

...

Keyword(s):

Systematic Review ◽

Longitudinal Strain ◽

Meta Analysis ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Poor Outcome ◽

Literature Searches ◽

Increased Risk ◽

Left And Right ◽

Longitudinal Strains

Abstract Background This systematic review and meta-analysis aimed to assess whether ventricular longitudinal strain can be used as a prognostication tool in patients with coronavirus disease 2019 (COVID-19). Methods Systematic literature searches of PubMed, Embase, and EuropePMC databases were performed on 16 November 2020. Left ventricular global longitudinal strain (LV-GLS) refers to LV contraction measurement using the speckle tracking-based method refers to the mean of strain values of the RV free wall (three segments) measured using echocardiography. The main outcome was poor outcome, defined as a composite of mortality and severe COVID-19. Results Seven studies comprising of 612 patients were included in meta-analysis. Six studies have mortality as their outcome, and 1 study has severity as their outcome. Patients with poor outcome have lower LV-GLS (SMD 1.15 (0.57, 1.72), p < 0.001; I2 70.4%). Each 1% decrease in LV-GLS was associated with 1.4x increased risk of poor outcome (OR 1.37 (1.12, 1.67), p = 0.002; I2 48.8%). Patients with poor outcome have lower RV-LS (SMD 1.18 (0.91, 1.45), p < 0.001; I2 0%). Each 1% decrease in RV-LS was associated with 1.3x increased risk of poor outcome (OR 1.25 (1.15, 1.35), p < 0.001; I2 11.8%). Subgroup analysis showed that for every 1% decrease in LV-GLS and RV-LS is increased mortality with OR of 1.30 (1.12, 1.50) and OR of 1.24 (1.14, 1.35), respectively. Conclusion This study shows that lower LV-GLS and RV-LS measurements were associated with poor outcome in patients with COVID-19. Trial registration PROSPERO CRD42020221144

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Abstract 14578: A Meta-analysis of Global Longitudinal Strain as a Predictor of Major Adverse Cardiac Events in Severe, Asymptomatic Aortic Stenosis With Preserved Ejection Fraction

Circulation ◽

10.1161/circ.132.suppl_3.14578 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Stefanie Furlan ◽

Leonardo Tamariz ◽

Robert Chait

Keyword(s):

Aortic Stenosis ◽

Ejection Fraction ◽

Longitudinal Strain ◽

Meta Analysis ◽

Global Longitudinal Strain ◽

Case Control ◽

Left Ventricular ◽

Cardiac Events ◽

Case Control Studies ◽

Reported Data

Introduction: The timing of surgical intervention in aortic stenosis (AS) is critical. Guidelines recommend aortic valve replacement in severe, asymptomatic AS with an ejection fraction (EF) less than 50%. Two-dimensional speckle tracking echocardiography is a relatively novel way to identify left ventricular dysfunction by measuring myocardial strain. Global longitudinal strain (GLS) is a measurement of deformation of the myocardium, and is considered a more sensitive marker for left ventricular dysfunction than EF. Hypothesis: Our aim was to determine if abnormal GLS predicts poor outcomes in severe, asymptomatic AS patients with a preserved EF. Methods: We conducted a meta-analysis and searched MEDLINE, EMBASE, Cochrane (2000 to 2015), supplemented by manual bibliographies of key relevant articles. We selected all cohort, cross-sectional, and case-control studies in which GLS was measured and major adverse cardiac events (MACE) were reported. In the case-control studies, we calculated the pooled standard mean difference (SMD) of GLS between those with MACE and those without MACE. In cohort studies, we calculated the pooled relative risk (RR) with the corresponding 95% confidence interval (CI) for incident MACE by using the fixed effects method. Results: Our search strategy identified 3 studies that met the inclusion criteria, and included 370 AS patients. Of the 3 studies, all reported data using a case-control design and 2 reported data using a cohort design. The median age of AS patients included was 72.6 years old, the median indexed aortic valve area was 0.44 (cm 2 /m 2 ), and the median ejection fraction was 64.2 (%). Of the 370 patients included in the analysis, 183 had MACE. Case-control studies revealed a pooled GLS SMD of 0.5 (95% CI: 0.30-0.69, p<0.01) for patients with MACE compared to those without MACE. Cohort studies revealed a RR of MACE of 2.07 (95% CI: 1.59-2.69, p<0.01) for those with abnormal GLS compared to those normal GLS. Conclusions: AS patients with a more positive global longitudinal strain value were more likely to have a major adverse cardiac event despite having a preserved EF and absence of symptoms. Therefore, if abnormal GLS is detected, earlier surgical intervention should be considered in severe, asymptomatic aortic stenosis.

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