Key result
Late gadolinium enhancement is linked to worse global longitudinal strain in nonischemic cardiomyopathy.
Why the study?
The utility of left ventricular global longitudinal strain by speckle-tracking echocardiography as a surrogate marker for detecting CMR late gadolinium enhancement in NICM patients was unclear.
Observational (n=41)
Single-blind
No
Worse GLS may mark fibrosis in nonischemic cardiomyopathy; hypothesis-generating and requires prospective validation before clinical use.
Background The presence of late gadolinium enhancement (LGE) using cardiovascular magnetic resonance (CMR), suggesting myocardial fibrosis is useful as a prognostic index in patients with nonischemic cardiomyopathy (NICM). The present study aimed to investigate whether left ventricular (LV) global longitudinal strain (GLS) using speckle-tracking echocardiography (STE) can be used as a surrogate marker for the detection of CMR-LGE in patients with NICM. Methods The study included 50 patients with NICM who underwent both STE and CMR. The presence, or absence of CMR-LGE was assessed in all patients, whereas STE-GLS was successfully analyzed in 41/50 (82%) patients. Therefore, the final study population comprised these 41 patients. Patients were divided into those with CMR-LGE (Group A; n = 18) and those without CMR-LGE (Group B; n = 23). Echocardiographic indexes including GLS was compared between the two groups. Results No significant differences were observed in LV end-diastolic and end-systolic volume indexes, LV ejection fraction, mitral E/A, deceleration time, E/e’, left atrial volume index, and the systolic transtricuspid pressure gradient between the Groups- A and B (113 ± 30 vs. 109 ± 24 mL/m2, 82 ± 27 vs. 78 ± 22 mL/m2, 28 ± 6 vs. 29 ± 7%, 1.3 ± 1.1 vs. 1.2 ± 0.8, 201 ± 82 vs. 214 ± 69 ms, 11.3 ± 3.7 vs. 11.7 ± 5.9, 49 ± 24 vs. 49 ± 13 mL/m2, and 29 ± 10 vs. 24 ± 7 mmHg, respectively). STE-GLS in Group A was significantly worse than that in Group B (− 7.6 ± 3.0% vs. −9.9 ± 3.2%, p = 0.01). According to receiver operating characteristic curve analysis, STE-GLS of − 7.9% was the best cut-off value for detection of CMR-LGE (sensitivity, 78%; specificity, 74%; area under the curve, 0.74). Conclusions STE-GLS may be used as a surrogate marker for the detection of CMR-LGE in patients with NICM.
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Ota et al. (2020) conducted an observational in Nonischemic cardiomyopathy (n=41). Late gadolinium enhancement on cardiovascular magnetic resonance vs. Absence of late gadolinium enhancement was evaluated on Global longitudinal strain using speckle-tracking echocardiography (STE-GLS) (p=0.01). In patients with nonischemic cardiomyopathy, global longitudinal strain was significantly worse in those with late gadolinium enhancement compared to those without (-7.6% vs -9.9%, p=0.01).
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