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July 1, 2017CirculationOpen Access

Global Longitudinal Strain and Left Atrial Volume Index Provide Incremental Prognostic Value in Patients With Hypertrophic Cardiomyopathy

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Key result

Each 1% lower GLS is linked to ~10% greater adverse event risk in HCM.

  • HR 1.10
  • 95% CI 1.03–1.19
  • P=0.007
  • n=427

Why the study?

Does the assessment of global longitudinal strain (GLS) and left atrial volume index (LAVI) improve prognostic risk stratification for adverse clinical outcomes in patients with hypertrophic cardiomyopathy?

Population

427 patients with hypertrophic cardiomyopathy, age ≥16 years, mean age 52±15 years, 66% men, based in The…

Comparison

Assessment of left ventricular global… vs Standard clinical and echocardiographic risk…

Design

Cohort

Follow-up

median 6.7 years (interquartile range, 3.3–10.0)

Authors

YHYasmine L. HiemstraCardiac ImagingPDPhilippe DebonnaireStructural Heart DiseaseMBMarianne BootsmaElectrophysiology

Discussion

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Member takes

Overview

GLS and LAVI may aid risk stratification in hypertrophic cardiomyopathy; leaves open prospective validation before changing practice.

Study Design

Type

Cohoert (n=427)

Multicenter

No

Structured PICO

Does the assessment of global longitudinal strain (GLS) and left atrial volume index (LAVI) improve prognostic risk stratification for adverse clinical outcomes in patients with hypertrophic cardiomyopathy?

P
Population
427 patients with hypertrophic cardiomyopathy (maximal LV hypertrophy ≥15 mm in absence of other causes), age ≥16 years, mean age 52±15 years, 66% men, based in The Netherlands.
I
Intervention
Assessment of left ventricular global longitudinal strain (GLS) and left atrial volume index (LAVI) via 2-dimensional echocardiography
C
Comparator
Standard clinical and echocardiographic risk factors, or patients with normal GLS (< -15%) and LAVI (< 34 mL/m2)
O
Outcome
Composite of all-cause mortality, heart transplantation, aborted sudden cardiac death (SCD), and appropriate implantable cardioverter defibrillator (ICD) therapycomposite

Main Result

Effect estimate: HR 1.10 (95% CI 1.03–1.19)

p-value: p=0.007

GLS and LAVI provide significant incremental prognostic value beyond standard clinical and echocardiographic risk factors for predicting mortality and severe cardiac events in patients with hypertrophic cardiomyopathy.

Limitations

  • Single-center study. Only GE echocardiographic equipment was used.
  • Retrospective design

Cite This Study

Hiemstra et al. (2017) conducted a cohoert in Hypertrophic Cardiomyopathy (n=427). Global longitudinal strain (GLS) was associated with a 10% increased risk (HR 1.10) of adverse outcomes for each 1% lower GLS value in patients with hypertrophic cardiomyopathy.

synapsesocial.com/papers/6978067bb4f402aaa34cc65ahttps://doi.org/10.1161/circimaging.116.005706
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Also Consider

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