Global Longitudinal Strain as a Major Predictor of Cardiac Events in Patients with Depressed Left Ventricular Function: A Multicenter Study

Mignot, Aude; Donal, Erwan; Zaroui, Amira; Réant, Patricia; Salem, Adrien; Hamon, Cécile; Monzy, Séverine; Roudaut, R.; Habib, Gilbert; Lafitte, Stéphane

doi:10.1016/j.echo.2010.07.019

Cited by 201 publications

(132 citation statements)

References 30 publications

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“…Given the need for more‐sensitive measures of LV performance, advances in image analysis have led to noninvasive methods for assessing cardiac mechanical function in multiple planes 2, 3. Numerous studies have now demonstrated that speckle tracking analyses of LV strain (ie, myocardial tissue deformation) applied to routine echocardiography offer significant incremental prognostic information over EF in patients with known cardiovascular disease (CVD) 4, 5, 6, 7, 8, 9. However, there are few studies of LV strain and outcomes in community‐dwelling individuals free of overt CVD 10, 11.…”

Section: Introductionmentioning

confidence: 99%

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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BackgroundThere are few data relating novel measures of left ventricular (LV) mechanical function to cardiovascular disease (CVD) outcomes in the community. Whether distinct components of LV mechanical function provide information regarding risk for different CVD outcomes is unclear.Methods and ResultsWe used speckle tracking echocardiography to quantify distinct components of LV mechanical function (measured as LV strain in multiple planes) in 2831 Framingham Offspring Study participants (mean age, 66 years; 57% women, 97% with LV fractional shortening >0.29). Participants were followed for 6.0±1.2 years for onset of 69 coronary heart disease (CHD), 71 heart failure (HF), and 199 mortality events. Adjusting for CVD risk factors, longitudinal LV strain appeared associated with incident CHD (hazards ratio [HR] per SD increment, 1.29; 95% confidence interval [CI], 1.00–1.67; P=0.05), whereas circumferential and radial strain were not (P>0.37 for both); however, the association of longitudinal strain with CHD was nonsignificant after Bonferroni correction. By contrast, circumferential strain was a significant predictor of incident HF (HR per SD increment, 1.79; 95% CI, 1.35–2.37; P<0.0001). Decrements in circumferential, radial, and longitudinal strain measures were related to all‐cause mortality (P<0.008 for all). Results remained similar in multivariable models adjusting additionally for the conventional echocardiographic measures of LV mass and fractional shortening.ConclusionsIn our large, community‐based sample, distinct components of LV mechanical function were associated with specific CVD outcomes. Additional studies are needed to replicate these findings and investigate the prognostic and therapeutic utility of these novel measures of LV mechanical function.

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Section: Introductionmentioning

confidence: 99%

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Cheng

McCabe

Larson

et al. 2015

JAHA

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“…Compared with LVEF, GLS is a more sensitive, objective, and reproducible modality for assessing cardiac functions, even among HF patients with preserved LVEF and CKD patients (11)(12)(13)(14). In the general population, GLS has proven to be a prognostic predictor (13,14). Reports suggest that subclinical LV systolic dysfunction, as indicated by GLS, is present in CKD and ESRD patients (8,12,15).…”

Section: Introductionmentioning

confidence: 99%

“…The more negative value of GLS, the better the LV function is. Compared with LVEF, GLS is a more sensitive, objective, and reproducible modality for assessing cardiac functions, even among HF patients with preserved LVEF and CKD patients (11)(12)(13)(14). In the general population, GLS has proven to be a prognostic predictor (13,14).…”

Section: Introductionmentioning

confidence: 99%

Association of Left Ventricular Longitudinal Strain with Mortality among Stable Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

Liu¹,

Sung

et al. 2013

Clinical Journal of the American Society of Nephrology

101

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SummaryBackground and objectives Little is known about the optimal echocardiographic parameters for risk stratification in stable dialysis patients with preserved left ventricular ejection fraction (LVEF) (ejection fraction $50%). Left ventricular (LV) global peak systolic longitudinal strain (GLS) is the ratio of the maximal change in myocardial longitudinal length in systole to the original length and reliably and accurately assesses LV function. During systole, LV myocardium in the longitudinal direction shortens and GLS is represented by a negative value. The more negative value of GLS, the better the LV function is. This study hypothesized that subtle abnormalities of GLS are associated with an adverse prognosis.Design, setting, participants, & measurements This prospective study collected clinical and echocardiographic data (including GLS) from 88 stable hemodialysis patients (mean age 67.0611.2 years; 35% men) with preserved LVEF. These patients were enrolled from December 2008 to January 2009 and were followed-up for 25.669.9 months. The primary outcome was all-cause mortality. Multivariate Cox regression analysis was used to investigate risk factors for mortality.Results The mortality group (n=24) had lower albumin levels, less negative GLS, and higher prevalence of coronary artery disease and diabetes mellitus than the survival group. Using a GLS cutoff value of 215%, the less negative GLS group (GLS $215%) had a higher mortality rate. Cox regression analyses revealed that lower albumin level (hazard ratio, 0.16; 95% confidence interval, 0.05 to 0.53; P=0.003) and less negative GLS (hazard ratio, 3.57; 95% confidence interval, 1.41 to 9.04; P=0.01) were independent predictors of all-cause mortality. Furthermore, less negative GLS was associated with a higher cardiovascular death rate.Conclusions Less negative GLS is predictive of poor prognosis among stable hemodialysis patients with preserved LVEF.

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“…Also, it is less load dependent than LVEF and may have higher prognostic value. In a multicenter study comparing echocardiographic parameters in patients with HF, global longitudinal strain (GLS) assessment, a parameter evaluating longitudinal aspect of myocardial contraction using deformation imaging, appeared to have a higher and more reliable prognostic value than LVEF for the prediction of cardiac events and cardiac deaths [20]. 2D speckle tracking strain has already been evaluated in studies for a total of more than 700 patients concomitantly to the administration of cardiotoxic anticancer agents, with encouraging results concerning its capability to diagnose subclinical LV dysfunction of subsequent clinical relevance [21][22][23][24][25][26][27].…”

Section: Imaging Techniques Echocardiographymentioning

confidence: 99%

Cardiac Imaging: Multimodality Advances and Surveillance Strategies in Detection of Cardiotoxicity

2017

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Contemporary cancer management has increased the overall number of cancer survivors, but cardiotoxicity remains a subject of concern, which is a major cause of noncancer mortality among survivors. Among the potential cardiovascular complications, left ventricular (LV) systolic dysfunction is a poor prognostic factor. The importance of its early detection is based on the principle that the likelihood of response to heart failure (HF) treatment is temporally related to the initiation of HF treatment. For these reasons, cardiac monitoring is commonly applied in general practice, based on serial measurements of LV ejection fraction (LVEF); transthoracic echocardiography (TTE) is generally used. However, the LVEF, as a diagnostic and predictive parameter, has significant limitations, which calls for more effective multimodality imaging strategies. This approach requires further study, but there is increasing available data in the literature, encouraging the combination of multimodality imaging parameters and techniques for early cancer therapeutic-related cardiac dysfunction (CTRCD) detection.

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Global Longitudinal Strain as a Major Predictor of Cardiac Events in Patients with Depressed Left Ventricular Function: A Multicenter Study

Cited by 201 publications

References 30 publications

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Distinct Aspects of Left Ventricular Mechanical Function Are Differentially Associated With Cardiovascular Outcomes and All‐Cause Mortality in the Community

Association of Left Ventricular Longitudinal Strain with Mortality among Stable Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

Cardiac Imaging: Multimodality Advances and Surveillance Strategies in Detection of Cardiotoxicity

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