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Global Longitudinal Strain to Predict Mortality in Patients With Acute Heart Failure

Journal of the American College of Cardiology, 2018-05, Vol.71 (18), p.1947-1957 [Peer Reviewed Journal]

2018 American College of Cardiology Foundation ;Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited May 8, 2018 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2018.02.064 ;PMID: 29724346

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  • Title:
    Global Longitudinal Strain to Predict Mortality in Patients With Acute Heart Failure
  • Author: Park, Jin Joo ; Park, Jun-Bean ; Park, Jae-Hyeong ; Cho, Goo-Yeong
  • Subjects: all-cause mortality ; Cardiac arrhythmia ; Cardiovascular disease ; Confidence intervals ; Diabetes ; Digital imaging ; Family medical history ; Heart diseases ; Heart failure ; Hypertension ; Laboratories ; Measurement methods ; Mortality ; myocardial strain ; Patients ; prognostic value ; Software ; Ventricle
  • Is Part Of: Journal of the American College of Cardiology, 2018-05, Vol.71 (18), p.1947-1957
  • Description: Heart failure (HF) is currently classified according to left ventricular ejection fraction (LVEF); however, the prognostic value of LVEF is controversial. Myocardial strain is a prognostic factor independently of LVEF. The authors sought to evaluate the prognostic value of global longitudinal strain (GLS) in patients with HF. GLS was measured in 4,172 consecutive patients with acute HF. Patients were categorized as either HF with reduced (LVEF <40%), midrange (LVEF 40% to 49%), or preserved ejection fraction (LVEF ≥50%) and were also classified as having mildly (GLS >12.6%), moderately (8.1% < GLS <12.5%), or severely (GLS ≤8.0%) reduced strain. The primary endpoint was 5-year all-cause mortality. Mean GLS was 10.8%, and mean LVEF was 40%. Overall, 1,740 (40.4%) patients had died at 5 years. Patients with reduced ejection fraction had slightly higher mortality than those with midrange or preserved ejection fraction (41%, 38%, and 39%, respectively; log-rank p = 0.031), whereas patients with reduced strain had significantly higher mortality (severely reduced GLS, 49%; moderately reduced GLS, 38%; mildly reduced GLS, 34%; log-rank p < 0.001). In multivariable analysis, each 1% increase in GLS was associated with a 5% decreased risk for mortality (p < 0.001). Patients with moderate (hazard ratio: 1.31; 95% confidence interval: 1.13 to 1.53) and severe GLS reductions (hazard ratio: 1.61; 95% confidence interval: 1.36 to 1.91) had higher mortality, but LVEF was not associated with mortality. In patients with acute HF, GLS has greater prognostic value than LVEF. Therefore, the authors suggest that GLS should be considered as the standard measurement in all patients with HF. This new concept needs validation in further studies. [Display omitted]
  • Publisher: United States: Elsevier Inc
  • Language: English
  • Identifier: ISSN: 0735-1097
    EISSN: 1558-3597
    DOI: 10.1016/j.jacc.2018.02.064
    PMID: 29724346
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    Alma/SFX Local Collection
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