Global longitudinal strain predicts long-term survival in patients with chronic ischemic cardiomyopathy

Bertini, Matteo, Ng, Arnold C. T., Antoni, M. Louisa, Nucifora, Gaetano, Ewe, See H., Auger, Dominique, Marsan, Nina Ajmone, Schalij, Martin J., Bax, Jeroen J. and Delgado, Victoria (2012) Global longitudinal strain predicts long-term survival in patients with chronic ischemic cardiomyopathy. Circulation: Cardiovascular Imaging, 5 3: 383-391. doi:10.1161/CIRCIMAGING.111.970434

Author Bertini, Matteo
Ng, Arnold C. T.
Antoni, M. Louisa
Nucifora, Gaetano
Ewe, See H.
Auger, Dominique
Marsan, Nina Ajmone
Schalij, Martin J.
Bax, Jeroen J.
Delgado, Victoria
Title Global longitudinal strain predicts long-term survival in patients with chronic ischemic cardiomyopathy
Journal name Circulation: Cardiovascular Imaging   Check publisher's open access policy
ISSN 1941-9651
Publication date 2012-05
Year available 2012
Sub-type Article (original research)
DOI 10.1161/CIRCIMAGING.111.970434
Volume 5
Issue 3
Start page 383
End page 391
Total pages 9
Place of publication Baltimore, MD, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract
Background: Left ventricular (LV) global longitudinal strain (GLS) is a measure of the active shortening of the LV in the longitudinal direction, which can be assessed with speckle-tracking echocardiography. The aims of this evaluation were to validate the prognostic value of GLS as a new index of LV systolic function in a large cohort of patients with chronic ischemic cardiomyopathy and to determine the incremental value of GLS to predict long-term outcome over other strong and well-established prognostic factors.

Methods and Results:
A total of 1060 patients underwent baseline clinical evaluation and transthoracic echocardiography. Median age was 66.9 years (interquartile range, 58.4, 74.2 years); 739 (70%) were men. The median follow-up duration for the entire patient population was 31 months. During the follow-up, 270 patients died and 309 patients reached the combined end point (all-cause mortality and heart failure hospitalization). Compared with survivors, patients who died (270, [25%]) had larger LV volumes (P<0.05), lower LV ejection fraction (P=0.004), higher wall motion score index (P=0.001), and greater impairment of LV GLS (P<0.001). After dichotomizing the population on the basis of the median value of LV GLS (-11.5%), patients with an LV GLS < - 11.5% had superior outcome compared with patients with an LV GLS >-11.5% (log-rank χ 2, 13.86 and 14.16 for all-cause mortality and combined end point, respectively, P<0.001 for both). On multivariate analysis, GLS was independently related to all-cause mortality (hazard ratio per 5% increase, 1.69; 95% confidence interval, 1.33-2.15; P<0.001) and combined end point (1.64; 95% confidence interval, 1.32-2.04; P<0.001).

The assessment of LV GLS with speckle-tracking echocardiography is significantly related to long-term outcome in patients with chronic ischemic cardiomyopathy.
Keyword Ischemic cardiomyopathy
2D speckle tracking
Longitudinal strain
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
Centre for Advanced Imaging Publications
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