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

Author:

Kažukauskienė Ieva,Balčiūnaitė Giedrė,Baltrūnienė Vaida,Čelutkienė Jelena,Maneikienė Vytė Valerija,Čibiras Sigitas,Ručinskas Kęstutis,Grabauskienė Virginija

Abstract

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.

Funder

Lietuvos Mokslo Taryba

European Union, EU-FP7, SARCOSI Project

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging,General Medicine

Reference44 articles.

1. Lund LH, Edwards LB, Dipchand AI, Goldfarb S, Kucheryavaya AY, Levvey BJ, Meiser B, Rossano JW, Yusen RD, Stehlik J. The Registry of the International Society for Heart and Lung Transplantation: thirty-third adult heart transplantation report—2016; focus theme: primary diagnostic indications for transplant. J Heart Lung Transplant. 2016;35:1158–69. https://doi.org/10.1016/j.healun.2016.08.017.

2. Bertini M, Ng ACT, Antoni ML, Nucifora G, Ewe SH, Auger D, Marsan NA, Schalij MJ, Bax JJ, Delgado V. Global longitudinal strain predicts long-term survival in patients with chronic ischemic cardiomyopathy. Circulation: Cardiovascular Imaging. 2012;5:383–91. https://doi.org/10.1161/CIRCIMAGING.111.970434.

3. Kaufmann D, Szwoch M, Kwiatkowska J, Raczak G, Daniłowicz-Szymanowicz L. Global longitudinal strain can predict heart failure exacerbation in stable outpatients with ischemic left ventricular systolic dysfunction. PLOS ONE. 2019;14:e0225829. https://doi.org/10.1371/journal.pone.0225829.

4. Motoki H, Borowski AG, Shrestha K, Troughton RW, Tang WHW, Thomas JD, Klein AL. Incremental prognostic value of assessing left ventricular myocardial mechanics in patients with chronic systolic heart failure. J Am Coll Cardiol. 2012;60:2074–81. https://doi.org/10.1016/j.jacc.2012.07.047.

5. Sengeløv M, Jørgensen PG, Jensen JS, Bruun NE, Olsen FJ, Fritz-Hansen T, Nochioka K, Biering-Sørensen T. Global longitudinal strain is a superior predictor of all-cause mortality in heart failure with reduced ejection fraction. JACC: Cardiovascular Imaging. 2015;8:1351–9. https://doi.org/10.1016/j.jcmg.2015.07.013.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3