Prognostic Relevance of Left Ventricular Global Longitudinal Strain in Patients With Heart Failure and Reduced Ejection Fraction
Por:
Chimed, S, Stassen, J, Galloo, X, Meucci, MC, Knuuti, J, Delgado, V, van der Bijl, P, Marsan, NA and Bax, JJ
Publicada:
1 sep 2023
Ahead of Print:
1 jul 2023
Resumen:
Patients with heart failure (HF) and reduced ejection fraction (HFrEF) are complex patients who often have a high prevalence of co-morbidities and risk factors. In the pres-ent study, we investigated the prognostic significance of left ventricular (LV) global longi-tudinal strain (GLS) along with important clinical and echocardiographic variables in patients with HFrEF. Patients who had a first echocardiographic diagnosis of LV systolic dysfunction, defined as LV ejection fraction <= 45%, were selected. The study population was subdivided into 2 groups based on a spline curve analysis derived optimal threshold value of LV GLS (<= 10%). The primary end point was occurrence of worsening HF, whereas the composite of worsening HF and all-cause death was chosen for the secondary end point. A total of 1,873 patients (mean age 63 +/- 12 years, 75% men) were analyzed. During a median follow-up of 60 months (interquartile range 27 to 60 months), 256 patients (14%) experienced worsening HF and the composite end point of worsening HF and all-cause mortality occurred in 573 patients (31%). The 5-year event-free survival rates for the primary and secondary end point were significantly lower in the LV GLS <= 10% group compared with the LV GLS >10% group. After adjustment for important clinical and echocardiographic variables, baseline LV GLS remained independently associated with a higher risk of worsening HF (hazard ratio 0.95, 95% confidence interval 0.90 to 0.99, p = 0.032) and the composite of worsening HF and all-cause mortality (hazard ratio 0.94, 95% confidence interval 0.90 to 0.97, p = 0.001). In conclusion, baseline LV GLS is associated with long-term prognosis in patients with HFrEF, independent of various clinical and echocardiographic predictors. (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/) (Am J Cardiol 2023;202:30-40)
Filiaciones:
Chimed, S:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Stassen, J:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Jessa Hosp, Dept Cardiol, Hasselt, Belgium
Galloo, X:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Meucci, MC:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Knuuti, J:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Univ Turku, Heart Ctr, Turku, Finland
Turku Univ Hosp, Turku, Finland
:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
van der Bijl, P:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Marsan, NA:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Bax, JJ:
Leiden Univ, Heart Lung Ctr, Dept Cardiol, Med Ctr, Leiden, Netherlands
Univ Turku, Heart Ctr, Turku, Finland
Turku Univ Hosp, Turku, Finland
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