Journal of the American Society of Echocardiography
Clinical InvestigationHeart FailureGlobal Longitudinal Strain as a Major Predictor of Cardiac Events in Patients with Depressed Left Ventricular Function: A Multicenter Study
Section snippets
Patient Population
One hundred eighty-one patients with chronic cardiomyopathy and LV EFs ≤ 45% were enrolled in a prospective multicenter study between January and November 2007 (Cardiologic Hospital and INSERM 828, Bordeaux University Hospital Center, Pessac, France; Timone Hospital, Cardiology Department, Marseille, France; and Pontchaillou University Hospital Center, Rennes, France). The exclusion criteria were recent acute HF (<3 months with clinical congestive HF), unstable patients (cardiac shock), severe
Patient Characteristics at Baseline
The study population’s baseline characteristics are shown in Table 1. The mean age was 64.5 ± 14 years, 74% were men, and 42.8% presented with ischemic cardiomyopathy. Most patients were in NYHA class II at the time of inclusion. The mean QRS interval was 135 ± 35 msec, while the mean LV EF was 29.9 ± 8.9%.
Patient Characteristics and Echocardiographic Parameters According to Cardiac Events
Characteristics of patients with HF and conventional echocardiographic parameters according to cardiac events are shown in Table 2. Overall, 20% of patients had cardiac events at the end of
Discussion
Our study demonstrates the prognostic significance of 2D GLS in a population of patients with chronic cardiomyopathy and LV dysfunction. The main results are as follows: (1) the GLS technique is a simple and highly feasible tool, with good reproducibility when applied to patients with LV dysfunction; (2) with a cutoff value of −7%, GLS can discriminate between patients with cardiac events and those with a better prognosis; and (3) regarding the evaluation of patient risk, longitudinal
Conclusions
GLS can be easily and robustly measured in patients with HF, demonstrating greater feasibility than other conventional parameters. Among prognostic factors obtained by echocardiography, GLS is the best predictor of cardiac events in this patient population. Our findings suggest a cutoff value of −7% to predict cardiac events at 12 months with high sensitivity and specificity. A multiparametric approach including GLS could better risk-stratify patient risk with HF than single-parameter
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