Key result
Adding GLS and GCS to the Echo Heart Failure Score improves 60-day readmission prediction to AUC ~0.85.
Why the study?
Ejection fraction is commonly used to assess readmission risk in heart failure, but speckle tracking parameters like GLS and GCS may be more sensitive predictors.
Does adding Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS) to the Echo Heart Failure Score (EHFS) improve prediction of 60-days readmission in patients with HFrEF?
Cohort (n=175)
No
Does adding Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS) to the Echo Heart Failure Score (EHFS) improve prediction of 60-days readmission in patients with HFrEF?
Adding Global Longitudinal Strain and Global Circumferential Strain to the Echo Heart Failure Score improves the prediction of 60-day readmission in patients with HFrEF.
Answers are grounded in this paper and cite their sources.
GLS and GCS may refine HF readmission prediction beyond LVEF; leaves open prospective validation before clinical adoption.
Introduction: The readmission rate due to heart failure increases every year in South Sulawesi. A Frequently used method for assessing readmission is an echocardiographic examination by measuring ejection fraction. However, recent studies show that the speckle tracking parameters are more sensitive to predict readmission of heart failure patients. In this study, we assess the role of Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS) parameters on the Echo Heart Failure Score (EHFS) as a 60-days readmission predictor in heart failure patients. Methods: We included 175 patients admitted through the inpatient installation of Integrated Heart Center Dr. Wahidin Sudirohusodo General Hospital. In addition, we reviewed up to 60 days after outpatient prospectively by collecting data through medical records. The correlation between echocardiographic parameters and readmissions was analyzed using the Spearman Rank Correlation. To determine each echocardiographic parameter's cut-off point, sensitivity, and specificity, we use Receiver Operating Characteristic (ROC) curve. Results:GLS and GCS are very sensitive and specific parameters in predicting 60-days readmission with an area under the curve (AUC) value > 0.7. This study shows that adding GLS and GCS parameters to the EHFS increases the predicted value (AUC 0.850 vs. 0.820) and sensitivity to 79%. Conclusion: GLS and GCS parameters additional on EHFS can help predict 60-days readmission of heart failure patients with sensitivity and specificity of 79% and 83%, respectively. The present study shows that with higher GLS and GCS scores on the EHFS, the risk of readmission in heart failure patients will increase.
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MUZAKKIR et al. (2021) conducted a cohort in Congestive heart failure with left ventricular systolic dysfunction (n=175). Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS) added to Echo Heart Failure Score (EHFS) vs. Echo Heart Failure Score (EHFS) alone was evaluated on Prediction of 60-day readmission (Area Under the Curve) (AUC 0.850, 95% CI 0.791-0.909, p=<0.001). Adding Global Longitudinal Strain and Global Circumferential Strain to the Echo Heart Failure Score improved the prediction of 60-day readmission in heart failure patients, increasing the AUC from 0.820 to 0.850.
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