3D-STE-derived global longitudinal strain predicted major adverse cardiac events (HR 0.79 per 1 SD increase) independently of clinical risk factors, but the added prognostic value was small and abolished when adjusted for 2D ejection fraction.
Cohort (n=529)
No
Does 3D-speckle tracking echocardiography improve prediction of major cardiovascular events beyond cardiovascular risk factors in a multi-ethnic general population?
3D-STE-derived LV myocardial strains predict MACE in a multi-ethnic general population, but provide only modest incremental prognostic value over traditional cardiovascular risk factors.
Hazard Ratio: 0.79 (95% CI 0.65–0.98)
p-value: p=0.029
3D-speckle tracking echocardiography(3D-STE) allows simultaneous assessment of ejection fraction(EF) and multidirectional strains, but its prognostic utility in the general population is unknown. We investigated if 3D-STE strains predicted a composite of major cardiac endpoints(MACE) beyond cardiovascular risk factors(CVDRF), and whether they were superior to 3D-EF. 529 participants in SABRE, a UK-based tri-ethnic general population cohort (69±6y; 76.6% male) with acceptable 3D-STE imaging were studied. Associations between 3D-EF or multidirectional myocardial strains and MACE(coronary heart disease(fatal/non-fatal), heart failure hospitalization, new-onset arrhythmia and cardiovascular mortality) were determined using Cox regression including adjustment for CVDRF and 2D-EF. Whether 3D-EF, global longitudinal strain(3D-GLS) and principle tangential strain(3D-PTS/3D-strain) improved cardiovascular risk stratification over CVDRF was investigated using a likelihood ratio test on a series of nested Cox proportional hazards models and Harrell's C statistics. During follow-up(median, 12y), there were 92 events. 3D-EF, 3D-GLS and 3D-PTS and 3D-RS were associated with MACE in unadjusted and models adjusted for CVDRF but not CVDRF+2D-EF. Compared to 3D-EF, both 3D-GLS and 3D-PTS slightly improved the predictive value over CVDRF for MACE, but the improvement was modest(C statistic increased from 0.698(0.647, 0.749) to 0.715(0.663, 0.766) comparing CVDRF with CVDRF +3D-GLS). 3D-STE-derived LV myocardial strains predicted MACE in a multi-ethnic general population sample of elderly individuals from the UK; however the added prognostic value of 3D-STE myocardial strains was small.
Saikhan et al. (Tue,) conducted a cohort in General population (n=529). 3D-speckle tracking echocardiography (3D-STE) derived myocardial strains (e.g., 3D-GLS) vs. Clinical cardiovascular risk factors (CVDRF) was evaluated on Major adverse cardiac endpoints (MACE) comprising new onset fatal and non-fatal coronary heart disease, heart failure hospitalization, new-onset arrhythmia, and cardiovascular mortality (HR 0.79, 95% CI 0.65-0.98, p=0.029). 3D-STE-derived global longitudinal strain predicted major adverse cardiac events (HR 0.79 per 1 SD increase) independently of clinical risk factors, but the added prognostic value was small and abolished when adjusted for 2D ejection fraction.
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