Global longitudinal strain values above -5.96% indicated a 12-fold higher risk of long-term adverse cardiac events (HR 12.47) in patients with non-ischemic dilated cardiomyopathy.
Cohort (n=41)
No
Does global longitudinal strain (GLS) and E/GLS predict elevated cardiac pressures and poor clinical outcomes in patients with non-ischemic dilated cardiomyopathy?
In patients with non-ischemic dilated cardiomyopathy, worsening global longitudinal strain (GLS) correlates with elevated invasive filling pressures and independently predicts a higher risk of death, heart transplantation, or LVAD implantation.
Effect estimate: HR 12.47 (95% CI 4.6-33.82)
p-value: p=<0.0001
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.
Kažukauskienė et al. (Sat,) conducted a cohort in Non-ischemic dilated cardiomyopathy (NI-DCM) (n=41). Global longitudinal strain (GLS) was evaluated on Composite of LV assist device implantation, heart transplantation, or cardiovascular death at 5 years (HR 12.47, 95% CI 4.6-33.82, p=<0.0001). Global longitudinal strain values above -5.96% indicated a 12-fold higher risk of long-term adverse cardiac events (HR 12.47) in patients with non-ischemic dilated cardiomyopathy.