Affiliation:
1. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Shin Street, Kwei-Shan District, Taoyuan City 33305, Taiwan
2. College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan District, Taoyuan City 33305, Taiwan
Abstract
Abstract
Aims
Left ventricular (LV) ejection fraction (EF) and global longitudinal strain (GLS) help identify heart failure (HF) patients who are at risk for adverse outcomes. This study aimed to determine whether global myocardial work (GMW), derived from non-invasive LV pressure-strain loops, can provide incremental prognostic information over EF and GLS in patients with HF and reduced EF (HFrEF).
Methods and results
We retrospectively analysed 508 patients (age 62.9 ± 15.8 years, 29.1% female) with LVEF ≤40%. The study endpoint was a composite of all-cause death and HF hospitalization. The incremental value of GMW over clinical and echocardiographic variables including EF and GLS for the association with the composite endpoint was assessed using Cox regression analyses. Over a 1-year follow-up, 183 patients reached the endpoint. Baseline variables associated with the endpoint were age, haemoglobin, LV end-systolic volume, New York Heart Association Class III or IV, E/e′ ratio, pulmonary artery systolic pressure, EF, and GLS. Cox regression analysis revealed that GMW [hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.05–1.25, per 100-mmHg% decrease] added incremental prognostic value over these variables. Both EF and GLS were not independent variables when GMW was included in the model. Patients with GMW <750 mmHg% were associated with a significantly higher risk of all-cause death and HF hospitalization (HR 3.33, 95% CI 2.31–4.80) than patients with GMW ≥750 mmHg%.
Conclusion
In patients with HFrEF, GMW provides incremental prognostic information over EF and GLS regarding risk of all-cause death and HF hospitalization.
Funder
Chang Gung Memorial Hospital
Ministry of Science and Technology of Taiwan
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging,General Medicine
Cited by
41 articles.
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