Key result
Left atrial reservoir strain ≤ 30% was associated with lower 10-year survival (71% vs 88%) and independently predicted all-cause mortality (HR 1.830; 95% CI 1.031-3.246; p=0.039).
Why the study?
Cardiac involvement in systemic sclerosis carries a negative prognosis, and left atrial reservoir strain has been proposed as a novel parameter of left ventricular diastolic function whose prognostic value needed evaluation.
Does left atrial reservoir strain (ƐR) predict all-cause mortality in patients with systemic sclerosis?
Cohort (n=311)
Yes
Does left atrial reservoir strain (ƐR) predict all-cause mortality in patients with systemic sclerosis?
Hazard Ratio: 1.83 (95% CI 1.031–3.246)
p-value: p=0.039
Left atrial reservoir strain is an independent predictor of all-cause mortality in patients with systemic sclerosis, suggesting its utility in risk stratification.
May aid risk stratification in SSc; leaves open incremental prognostic value pending validation.
Systemic sclerosis (SSc) is a multisystemic autoimmune disorder in which cardiac involvement is frequent and portends negative prognosis. Left ventricular (LV) diastolic dysfunction is one of the most common cardiac alterations in these patients, and left atrial (LA) reservoir strain (ƐR) measurement using speckle tracking echocardiography has been proposed as a novel parameter for a better assessment of LV diastolic function. Therefore, the aim of this study was to test the prognostic value of ƐR in a large multicenter cohort of SSc patients. In total, 311 SSc patients (54 ± 14 years, 85% female) were included from two different centers. Echocardiography was performed at the time of first visit, including ƐR measurement. Over a median follow-up of 132 (interquartile range: 110 to 157) months, 67 (21.5%) patients experienced the outcome of all-cause mortality. Spline curve analysis identified an optimal cut-off value of 30% for ƐR, and patients with ƐR ≤ 30% showed a 10-year cumulative survival rate of 71% as compared to 88% for patients with ƐR > 30% (log-rank p < 0.001). At the multivariable Cox regression analysis, ƐR was independently associated with the endpoint (HR 1.830; 95% confidence interval (CI) 1.031–3.246; p = 0.039) together with age (HR 1.071, 95% CI 1.043 to 1.099; p < 0.001), sex (female) (HR 0.444, 95% CI 0.229 to 0.861; p = 0.016), and diffusing lung capacity for carbon monoxide (HR 0.969 95% CI 0.956 to 0.982; p < 0.001). ƐR is of independent prognostic value in SSc and might help optimizing risk stratification in these patients.
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Giucă et al. (2024) conducted a cohort in Systemic sclerosis (n=311). Left atrial reservoir strain (ƐR) ≤ 30% vs. Left atrial reservoir strain (ƐR) > 30% was evaluated on all-cause mortality (HR 1.830, 95% CI 1.031-3.246, p=0.039). Left atrial reservoir strain ≤ 30% was associated with lower 10-year survival (71% vs 88%) and independently predicted all-cause mortality (HR 1.830; 95% CI 1.031-3.246; p=0.039).
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