Left Ventricular Global Longitudinal Strain as a Predictor for Left Ventricular Reverse Remodeling in Dilated Cardiomyopathy

Abstract

BACKGROUND: A considerable number of patients with dilated cardiomyopathy (DCM) experience left ventricular reverse remodeling (LVRR). LV global longitudinal strain (LV GLS) offers sensitive and reproducible measurement of myocardial dysfunction. The authors sought to evaluate whether LV GLS at the time of diagnosis may predict LVRR in DCM patients with sinus rhythm and investigate its prognostic role in long-term follow-up in this population. METHODS: We enrolled 160 DCM patients with sinus rhythm who had been initially diagnosed, evaluated, and followed at our institute. We analyzed their medical records and echocardiographic data. RESULTS: During the mean follow-up duration of 37.3 ± 21.7 months, LVRR occurred in 28% of patients (n = 45). The initial LV ejection fraction (LVEF) of patients who recovered LV function was 26.1 ± 7.9%, which was not significantly different from the value of 27.1 ± 7.4% (p = 0.49) in those who did not recover. There was a moderate and highly significant correlation between baseline LV GLS (−%) and follow-up LVEF (r = 0.717; p < 0.001). Using multivariate Cox analysis, LV GLS (hazard ratio: 1.474, 95% confidence interval: 1.170-1.856; p = 0.001) was an independent predictor of LVRR. CONCLUSIONS: We demonstrated that LV GLS was an independent predictor for LVRR and the optimal cutoff point of LV GLS for LVRR was −10% in DCM patients with sinus rhythm. There was a significant correlation between baseline LV GLS and follow-up LVEF.

The relation between left ventricular global longitudinal strain and troponin levels in patients hospitalized with COVID-19 pneumonia

“…LVGLS assessment was carried out by a single pyhsician (BBK). The normal limit of GLS, which is expressed as a negative value, was < -18% [7,10]. In other words, the more negative values demonstrate the better cardiac function.…”

“…It permits evaluation of the myocardial strain, thereby providing detailed data about the LV deformation. It has also been reported that LVGLS presents more objective information than LVEF [7] and provides additional prognostic information.…”

Effect of Empagliflozin on Left Ventricular Volumes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure With Reduced Ejection Fraction (SUGAR-DM-HF)

“…Our patients had LV GLS values considerably below normal and consistent with those described in other studies in patients with HFrEF. 6 , 22 As a relatively new measure of myocardial systolic function, the only other trial of LV remodeling in HFrEF to investigate LV GLS was the EVALUATE-HF trial. 6 In comparison with enalapril, sacubitril/valsartan had no effect on LV GLS in that trial.…”

Evaluation the relationship of left ventricular global longitudinal strain and laboratory parameters in discharged patients with COVID-19: a follow-up study

“…Recently, GLS analysis using STE is a sensitive and reliable method for determining occult myocardial injury and it has additional prognostic information [ 34 , 35 ]. Longitudinal myocardial fibres are located in the subendocardium which is most vulnerable to ischemia or injury [ 36 ].…”