Key result
LV GLS <15% linked to ~190% greater risk of major events after a stroke.
Why the study?
LV GLS is a prognostic biomarker in heart failure, but its prognostic value after a stroke remained to be determined.
Does left ventricular global longitudinal strain (LV GLS) predict adverse outcomes in patients admitted for stroke or TIA?
Cohort (n=334)
No
Does left ventricular global longitudinal strain (LV GLS) predict adverse outcomes in patients admitted for stroke or TIA?
Effect estimate: HR 2.9
p-value: p=<0.01
LV GLS <15% is an independent prognostic biomarker for adverse cardiovascular and mortality outcomes in patients following a stroke or TIA.
LV GLS <15% may identify higher-risk post-stroke patients; extends prior HF data but leaves open prospective validation.
Background Left ventricular global longitudinal strain (LV GLS) is used as a surrogate of subclinical left ventricular dysfunction. The LV GLS is a prognostic biomarker in patients with heart failure. Aims To determine the prognostic value of left ventricular global longitudinal strain after a stroke. Materials and Methods All consecutive patients admitted in a stroke center (France) because of an ischemic stroke, transient ischemic attack (TIA) or a hemorrhagic stroke, were included retrospectively in this study. LV GLS was evaluated according to Guidelines. The primary outcome was a composite outcome: death, acute heart failure, acute myocardial infarction, vascular events, supra-ventricular and ventricular arrhythmia. Results The study included 334 patients (median age 72 years, 39% female) from April 2021 to November 2024: 261 patients (78%) had an ischemic stroke, 63 patients (19 %) a TIA, and 8 patients (2.4%) had a hemorrhagic stroke. Overall, 67 patients (20%) had diabetes, and 195 patients (58%) disclosed history of arterial hypertension. The median NIHSS (NIH stroke scale) score was 2 [0-6.7]. The median left ventricular ejection fraction (LVEF) was 60% [58-65] whereas the median LV GLS was 15% [12-17]. After a median follow up of 96 months, the primary outcome occurred in 54 patients (16%). The LV GLS was associated with age (p<0.001), diabetes (p 0.048), arterial hypertension (p<0.001), body mass index (p=0.047), NIHSS score (p<0.001), Nt pro BNP (p<0.001), troponin (p<0.001), LVEF (p<0.001), left atrial area (p<0.001), E/Ea lateral (p<0.001), TAPSE (p<0.01) and systolic pulmonary artery pressure (p <0.001). Using a Cox model, in multivariate analysis, a LV GLS <15% was significantly associated with the primary outcome (HR 2.9, p<0.01) (figure 1). The LA size (HR 1.07, p<0.001) and the LVEF (HR 0.96, p 0.014) were independently associated with the primary outcome. Conclusion LV GLS can be used as an independent prognostic biomarker after an episode of strokeFigure 1 : Kaplan-Meier curve
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Fayssoil et al. (2025) conducted a cohort in Ischemic stroke, transient ischemic attack, or hemorrhagic stroke (n=334). Left ventricular global longitudinal strain (LV GLS) <15% vs. LV GLS ≥15% was evaluated on Composite of death, acute heart failure, acute myocardial infarction, vascular events, supra-ventricular and ventricular arrhythmia (HR 2.9, p=<0.01). A left ventricular global longitudinal strain <15% was significantly associated with an increased risk of the primary composite outcome after a stroke (HR 2.9, p<0.01).
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