Title Left ventricular global longitudinal strain predicts elevated cardiac pressures and poor clinical outcomes in patients with non-ischemic dilated cardiomyopathy /
Authors Kažukauskienė, Ieva ; Balčiūnaitė, Giedrė ; Baltrūnienė, Vaida ; Čelutkienė, Jelena ; Maneikienė, Vytė Valerija ; Čibiras, Sigitas ; Ručinskas, Kęstutis ; Grabauskienė, Virginija
DOI 10.1186/s12947-021-00254-1
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Is Part of Cardiovascular ultrasound.. London : BioMed Central. 2021, vol. 19, no. 1, art. no. 21, p. [1-13].. eISSN 1476-7120
Keywords [eng] global longitudinal strain ; heart failure ; invasive hemodynamics ; non-ischemic dilated cardiomyopathy ; prognosis ; strain-based index
Abstract [eng] BACKGROUND: Risk stratification in patients with non-ischemic dilated cardiomyopathy (NI-DCM) is essential to treatment planning. Global longitudinal strain (GLS) predicts poor prognosis in various cardiac diseases, but it has not been evaluated in a cohort of exclusively NI-DCM. Although deformation parameters have been shown to reflect diastolic function, their association with other hemodynamic parameters needs further elucidation. We aimed to evaluate the association between GLS and E/GLS and invasive hemodynamic parameters and assess the prognostic value of GLS and E/GLS in a prospective well-defined pure NI-DCM cohort. METHODS AND RESULTS: Forty-one patients with NI-DCM were enrolled in the study. They underwent a standard diagnostic workup, including transthoracic echocardiography and right heart catheterization. During a five-year follow-up, 20 (49%) patients reached the composite outcome measure: LV assist device implantation, heart transplantation, or cardiovascular death. Pulmonary capillary wedge pressure (PCWP), mean pulmonary artery pressure, pulmonary vascular resistance (PVR) correlated with GLS and E/GLS (p  3 Wood units). Survival analysis showed GLS and E/GLS to be associated with short- and long-term adverse cardiac events (p < 0.05). GLS values above thresholds of -5.34% and -5.96% indicated 18- and 12-fold higher risk of poor clinical outcomes at one and five years, respectively. Multivariate Cox regression analysis revealed that GLS is an independent long-term outcome predictor. CONCLUSION: GLS and E/GLS correlate with invasive hemodynamics parameters and identify patients with elevated PCWP and high PVR. GLS and E/GLS predict short- and long-term adverse cardiac events in patients with NI-DCM. Worsening GLS is associated with incremental risk of long-term adverse cardiac events and might be used to identify high-risk patients.
Published London : BioMed Central
Type Journal article
Language English
Publication date 2021
CC license CC license description