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Open Access 01-12-2021 | Cardiomyopathy | Research

Left ventricular global longitudinal strain predicts elevated cardiac pressures and poor clinical outcomes in patients with non-ischemic dilated cardiomyopathy

Authors: Ieva Kažukauskienė, Giedrė Balčiūnaitė, Vaida Baltrūnienė, Jelena Čelutkienė, Vytė Valerija Maneikienė, Sigitas Čibiras, Kęstutis Ručinskas, Virginija Grabauskienė

Published in: Cardiovascular Ultrasound | Issue 1/2021

Abstract

Background

Risk stratification in patients with non-ischemic dilated cardiomyopathy (NI-DCM) is essential to treatment planning. Global longitudinal strain (GLS) predicts poor prognosis in various cardiac diseases, but it has not been evaluated in a cohort of exclusively NI-DCM. Although deformation parameters have been shown to reflect diastolic function, their association with other hemodynamic parameters needs further elucidation. We aimed to evaluate the association between GLS and E/GLS and invasive hemodynamic parameters and assess the prognostic value of GLS and E/GLS in a prospective well-defined pure NI-DCM cohort.

Methods and results

Forty-one patients with NI-DCM were enrolled in the study. They underwent a standard diagnostic workup, including transthoracic echocardiography and right heart catheterization. During a five-year follow-up, 20 (49%) patients reached the composite outcome measure: LV assist device implantation, heart transplantation, or cardiovascular death.

Pulmonary capillary wedge pressure (PCWP), mean pulmonary artery pressure, pulmonary vascular resistance (PVR) correlated with GLS and E/GLS (p < 0.05). ROC analysis revealed that GLS and E/GLS could identify elevated PCWP (≥ 15 mmHg) and PVR (> 3 Wood units). Survival analysis showed GLS and E/GLS to be associated with short- and long-term adverse cardiac events (p < 0.05). GLS values above thresholds of –5.34% and -5.96% indicated 18- and 12-fold higher risk of poor clinical outcomes at one and five years, respectively. Multivariate Cox regression analysis revealed that GLS is an independent long-term outcome predictor.

Conclusion

GLS and E/GLS correlate with invasive hemodynamics parameters and identify patients with elevated PCWP and high PVR. GLS and E/GLS predict short- and long-term adverse cardiac events in patients with NI-DCM. Worsening GLS is associated with incremental risk of long-term adverse cardiac events and might be used to identify high-risk patients.

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Title: Left ventricular global longitudinal strain predicts elevated cardiac pressures and poor clinical outcomes in patients with non-ischemic dilated cardiomyopathy
Authors: Ieva Kažukauskienė
Giedrė Balčiūnaitė
Vaida Baltrūnienė
Jelena Čelutkienė
Vytė Valerija Maneikienė
Sigitas Čibiras
Kęstutis Ručinskas
Virginija Grabauskienė
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Cardiomyopathy
Heart Failure
Published in: Cardiovascular Ultrasound / Issue 1/2021
Electronic ISSN: 1476-7120
DOI: https://doi.org/10.1186/s12947-021-00254-1

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