Left ventricular global longitudinal strain (HR 0.71; 95% CI 0.63-0.79) and left atrial reservoir strain (HR 0.96; 95% CI 0.93-0.98) independently predicted adverse events, superior to LVEF.
Cohort (n=192)
Do left ventricular global longitudinal strain and left atrial reservoir strain improve the prediction of adverse events compared to LVEF alone in patients with chronic CAD and reduced systolic function?
GLS and LARS provide significant incremental prognostic value over LVEF for predicting adverse cardiovascular events in patients with chronic CAD and reduced systolic function.
Hazard Ratio: 0.71 (95% CI 0.63–0.79)
p-value: p=<0.001
OBJECTIVE: This study aimed to investigate the predictive value of left ventricular global longitudinal strain (GLS) and left atrial reservoir strain (LARS) on adverse events in chronic coronary artery disease (CAD) patients with reduced systolic function. METHODS: A total of 192 consecutive patients clinically diagnosed with chronic CAD and left ventricular ejection fraction (LVEF) ≤ 50% were finally included. Multiple strain parameters were analyzed with speckle tracking echocardiography. The composite endpoint included all-cause mortality, rehospitalization due to heart failure, myocardial infarction, and stroke. RESULTS: Patients experiencing the endpoint showed lower LVEF, lower absolute GLS and LARS than those without events. Both GLS (AUC = 0.82 GLS vs. 0.58 LVEF, p < 0.001) and LARS (AUC = 0.71 LARS vs. 0.58 LVEF, p = 0.033) were superior to LVEF in predicting adverse events. Multivariate cox regression analysis showed that both GLS (hazard ratio, 0.71; 95% CI, 0.63-0.79; p < 0.001) and LARS (hazard ratio, 0.96; 95% CI, 0.93-0.98; p < 0.001) were independent predictors for the endpoint. The addition of LARS (global chi-squared, 35.7 vs. 17.4; p < 0.05), GLS (global chi-squared, 58.6 vs. 17.4; p < 0.05) or both LARS and GLS (global chi-squared, 79.6 vs. 17.4; p < 0.05) to LVEF in the prediction model significantly improved its performance. The same significant improvement was also shown in the subgroups of mild (30% < LVEF ≤ 50%) and severe (LVEF ≤ 30%) reduced systolic function. CONCLUSIONS: Regarding CAD patients with reduced LVEF, both GLS and LARS are superior to LVEF in predicting adverse events, providing significant incremental value to LVEF.
Lu et al. (Mon,) conducted a cohort in Chronic coronary artery disease with reduced systolic function (n=192). Left ventricular global longitudinal strain (GLS) and left atrial reservoir strain (LARS) vs. Left ventricular ejection fraction (LVEF) was evaluated on Composite of all-cause mortality, rehospitalization due to heart failure, myocardial infarction, and stroke (HR 0.71, 95% CI 0.63-0.79, p=<0.001). Left ventricular global longitudinal strain (HR 0.71; 95% CI 0.63-0.79) and left atrial reservoir strain (HR 0.96; 95% CI 0.93-0.98) independently predicted adverse events, superior to LVEF.