scholarly journals Left ventricular global longitudinal strain predicts elevated cardiac pressures and poor clinical outcomes in patients with non-ischemic dilated cardiomyopathy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ieva Kažukauskienė ◽  
Giedrė Balčiūnaitė ◽  
Vaida Baltrūnienė ◽  
Jelena Čelutkienė ◽  
Vytė Valerija Maneikienė ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Clinical Outcomes ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Hemodynamic Parameters ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Short And Long Term ◽  
Non Ischemic Dilated Cardiomyopathy

Abstract Background Risk stratification in patients with non-ischemic dilated cardiomyopathy (NI-DCM) is essential to treatment planning. Global longitudinal strain (GLS) predicts poor prognosis in various cardiac diseases, but it has not been evaluated in a cohort of exclusively NI-DCM. Although deformation parameters have been shown to reflect diastolic function, their association with other hemodynamic parameters needs further elucidation. We aimed to evaluate the association between GLS and E/GLS and invasive hemodynamic parameters and assess the prognostic value of GLS and E/GLS in a prospective well-defined pure NI-DCM cohort. Methods and results Forty-one patients with NI-DCM were enrolled in the study. They underwent a standard diagnostic workup, including transthoracic echocardiography and right heart catheterization. During a five-year follow-up, 20 (49%) patients reached the composite outcome measure: LV assist device implantation, heart transplantation, or cardiovascular death. Pulmonary capillary wedge pressure (PCWP), mean pulmonary artery pressure, pulmonary vascular resistance (PVR) correlated with GLS and E/GLS (p < 0.05). ROC analysis revealed that GLS and E/GLS could identify elevated PCWP (≥ 15 mmHg) and PVR (> 3 Wood units). Survival analysis showed GLS and E/GLS to be associated with short- and long-term adverse cardiac events (p < 0.05). GLS values above thresholds of –5.34% and -5.96% indicated 18- and 12-fold higher risk of poor clinical outcomes at one and five years, respectively. Multivariate Cox regression analysis revealed that GLS is an independent long-term outcome predictor. Conclusion GLS and E/GLS correlate with invasive hemodynamics parameters and identify patients with elevated PCWP and high PVR. GLS and E/GLS predict short- and long-term adverse cardiac events in patients with NI-DCM. Worsening GLS is associated with incremental risk of long-term adverse cardiac events and might be used to identify high-risk patients.

Global longitudinal strain from resting echocardiogram is associated with long-term adverse cardiac outcomes in patients with suspected coronary artery disease

Perfusion ◽  
2017 ◽  
Vol 32 (7) ◽  
pp. 529-537 ◽  
Author(s):  
Ajay Yadlapati ◽  
Timothy R. Maher ◽  
James D. Thomas ◽  
Mark Gajjar ◽  
Kofo O. Ogunyankin ◽  
...  
Keyword(s):  
Stress Echocardiography ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Myocardial Strain ◽  
Regional Wall Motion ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Cardiac Testing

Purpose: Measuring myocardial strain using two-dimensional speckle tracking echocardiography has emerged as a new tool to identify subclinical ventricular dysfunction. Abnormal strain has been shown to have superior sensitivity compared with dobutamine stress echocardiography for viability assessment; however, there is a paucity of data regarding the prediction of long-term major adverse cardiac events. We compared the prognostic ability of both global longitudinal strain (GLS) from resting echocardiograms to regional wall motion score index (WMSI) from stress echocardiograms in their ability to predict long-term major adverse cardiac events. Methods: Patients referred for stress echocardiography, who also underwent coronary angiography within 3 months of stress echo (n=122), were enrolled. Patients with reduced ejection fractions (<40%) were excluded. Patients were followed for a median of 3.4 years for major adverse cardiac events, readmissions and repeat cardiac testing. Results: Patients with abnormal GLS (GLS <16.8%) from the resting echocardiogram obtained as part of the exercise echocardiogram experienced a significantly shorter time to major adverse cardiac events (p=0.026), first cardiovascular hospitalization and repeat cardiac testing (p=0.0011) compared to those with normal GLS. Abnormal GLS appears to be a better predictor than abnormal WMSI in predicting major adverse cardiac events (p=0.174) and time to first cardiovascular hospitalization or repeat cardiac testing (p=0.0093). Conclusion: GLS may be a better predictor of long-term major adverse cardiac events, readmissions and repeat cardiac testing than WMSI in patients undergoing stress echocardiography.

scholarly journals Strain Echocardiography Is a Promising Tool for the Prognostic Assessment of Sarcoidosis

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1065
Author(s):  
Paolo Cameli ◽  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Mariangela Vigna ◽  
Giuseppe De Carli ◽  
...  
Keyword(s):  
Longitudinal Strain ◽  
Pulmonary Function Tests ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Prognostic Assessment ◽  
Promising Tool ◽  
Adverse Cardiac Events

Sarcoidosis is a systemic chronic granulomatous disease with significant morbidity and mortality. Although basic transthoracic echocardiography (TTE) is not recommended for the assessment of sarcoidosis, speckle tracking echocardiography (STE) has emerged as more sensitive for the early detection of cardiac sarcoidosis and its outcome. The aim of the study was to assess the utility of left atrial and left ventricular longitudinal STE for the prediction of major adverse cardiac events (MACE) and sarcoidosis relapses. We enrolled 172 consecutive patients with sarcoidosis who underwent TTE and pulmonary function tests (PFTs). All patients were followed for a sarcoidosis relapse and MACE. During a median follow-up of 2217 days, 8 deaths, 23 MACE and 36 sarcoidosis relapses were observed. LV global longitudinal strain (GLS) was significantly lower in patients with MACE (p = 0.025). LV-GLS < 17.13% (absolute value) was identified as a fair predictor of MACE. Concerning the sarcoidosis control, TTE revealed a reduction of the LV ejection fraction (p = 0.0432), tricuspid annular plane systolic excursion (p = 0.0272) and global peak atrial longitudinal strain (PALS, p = 0.0012) in patients with relapses. PALS < 28.5% was the best predictor of a sarcoidosis relapse. Our results highlight a potential role of LV-GLS and PALS as prognostic markers in sarcoidosis, supporting the use of STE in the clinical management of these patients.

Abstract 20577: Combination of Global Longitudinal Strain and Sympathetic Nervous Dysfunction Predicts Cardiac Events in Patients With Non-Ischemic Dilated Cardiomyopathy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Misato Chimura ◽  
Tetsuari Onishi ◽  
Hiroya Kawai ◽  
Shinishiro Yamada ◽  
Yoshinori Yasaka
Keyword(s):  
Heart Failure ◽  
Regression Analysis ◽  
Dilated Cardiomyopathy ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Nervous Activity ◽  
Left Ventricular ◽  
Sympathetic Nervous Activity ◽  
Cardiac Events ◽  
Sympathetic Nervous

Introduction: It has been reported that sympathetic nervous dysfunction by 123I-metaiodobenzylguanidine (MIBG) is associated with worse outcome in dilated cardiomyopathy (DCM) patients. However, the association between sympathetic nervous function and myocardial strain is not established. Hypothesis: Global longitudinal strain (GLS) by two-dimensional speckle-tracking echocardiography (2DSTE) is correlated with sympathetic nervous activity, and stratifies DCM patients at risk for cardiac events with a combination of sympathetic nervous activity. Methods: We studied 71 patients who had admitted to a cardiology department with heart failure at the initial visit (age 61±13 years, 45 males, LV ejection fraction (EF) 30±8 %). All patients underwent MIBG imaging for the delayed heart to mediastinum ratio (H/M), and echocardiography with conventional assessment including left atrial volume (LAV), LV end-diastolic and end-systolic volume (LVEDV, LVESV), LVEF, mitral regurgitation grade (MR), early transmitral flow to atrial contraction (E/A) and with 2DSTE analysis for GLS expressed with an absolute value. Cardiac events were assessed according to death and hospitalization with heart failure. Results: There were 21 cardiac events in the follow-up period for 4.9±2.3 years. Univariate regression analysis showed LAV, LVEDV, LVESV, LVEF, MR, E/A and GLS had a significant correlation with delayed H/M (all p < 0.05). Multivariate regression analysis revealed that GLS was an independent predictor of delayed H/M. Dividing all patients into 4 groups by the median of GLS in patients with delayed H/M >1.6 or≤1.6, the combination of the worse delayed H/M and the worse GLS was significantly associated with cardiac events (p=0.03). Conclusions: Left ventricular GLS is significantly correlated with delayed H/M and can be useful to stratify the risk in DCM patients with a combination of delayed H/M.

scholarly journals Impaired RV Global Longitudinal Strain Is Associated With Poor Long-Term Clinical Outcomes in Patients With Acute Inferior STEMI

2015 ◽  
Vol 8 (2) ◽  
pp. 161-169 ◽  
Author(s):  
Soo Jin Park ◽  
Jae-Hyeong Park ◽  
Hyeon Seok Lee ◽  
Min Su Kim ◽  
Yong Kyu Park ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain
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