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Predictive value of global longitudinal strain by left ventricular ejection fraction.

MedStar author(s):

2055-5822

Name of journal: ESC heart failureAbstract: BACKGROUND: The predictive value of left ventricular (LV) global longitudinal strain (GLS) to predict outcomes in different left ventricular ejection fraction (LVEF) cohorts is not well known. We aimed to assess the role of LV GLS predicting outcomes in HF patients by LVEF.CONCLUSIONS: In this MADIT-CRT sub-study, LV GLS identified patients at higher risk of VT/VF, HF/death risk independently of conventional clinical parameters in patients with LVEF <= 30%, but not in patients with LVEF > 30%. Copyright © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.METHODS: In the Multicenter Automatic Defibrillator Implantation Trial Cardiac Resynchronization Therapy (MADIT-CRT), we studied 1077 patients (59%) with 2D speckle tracking data available, 437 patients with LVEF > 30% and 640 with LVEF <= 30%. Baseline LV GLS was stratified in tertiles in both LVEF subgroups. The primary endpoint was ventricular tachycardia/fibrillation (VT/VF) or death; the secondary endpoint was heart failure (HF) or death.RESULTS: In patients with LVEF <= 30%, a higher tertile GLS (T3, less contractility) was associated with a higher rate of VT/VF/death (P < 0.001), with similar association in patients with LVEF > 30% (P = 0.057). In patients with LVEF <= 30%, a higher tertile GLS was also associated with a higher rate of HF/death. In multivariable models, LV GLS predicted VT/VF or death in the LVEF <= 30% subgroup [T1 vs. T2/3 HR = 1.67 (1.16-2.38), P = 0.005], but not in those with LVEF > 30% [T1 vs. T2.3 HR = 1.32 (0.86-2.04), P = 0.21]. LV GLS predicted HF/death in the LVEF <= 30% subgroup [T1 vs T2/3 HR = 2.00 (1.30-3.13), P = 0.002], but not in in those with LVEF > 30%.All authors: Arany-Lao-Kan G, Goldenberg I, Kutyifa V, Lang RM, McNitt S, Medvedofsky D, Merkely B, Solomon SD, Tung RFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1002/ehf2.14193

Date added to catalog: 06/01/2023

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Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	36988162	Available		36988162

BACKGROUND: The predictive value of left ventricular (LV) global longitudinal strain (GLS) to predict outcomes in different left ventricular ejection fraction (LVEF) cohorts is not well known. We aimed to assess the role of LV GLS predicting outcomes in HF patients by LVEF.

CONCLUSIONS: In this MADIT-CRT sub-study, LV GLS identified patients at higher risk of VT/VF, HF/death risk independently of conventional clinical parameters in patients with LVEF <= 30%, but not in patients with LVEF > 30%. Copyright © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

METHODS: In the Multicenter Automatic Defibrillator Implantation Trial Cardiac Resynchronization Therapy (MADIT-CRT), we studied 1077 patients (59%) with 2D speckle tracking data available, 437 patients with LVEF > 30% and 640 with LVEF <= 30%. Baseline LV GLS was stratified in tertiles in both LVEF subgroups. The primary endpoint was ventricular tachycardia/fibrillation (VT/VF) or death; the secondary endpoint was heart failure (HF) or death.

RESULTS: In patients with LVEF <= 30%, a higher tertile GLS (T3, less contractility) was associated with a higher rate of VT/VF/death (P < 0.001), with similar association in patients with LVEF > 30% (P = 0.057). In patients with LVEF <= 30%, a higher tertile GLS was also associated with a higher rate of HF/death. In multivariable models, LV GLS predicted VT/VF or death in the LVEF <= 30% subgroup [T1 vs. T2/3 HR = 1.67 (1.16-2.38), P = 0.005], but not in those with LVEF > 30% [T1 vs. T2.3 HR = 1.32 (0.86-2.04), P = 0.21]. LV GLS predicted HF/death in the LVEF <= 30% subgroup [T1 vs T2/3 HR = 2.00 (1.30-3.13), P = 0.002], but not in in those with LVEF > 30%.

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