Global longitudinal strain can predict heart failure exacerbation in stable outpatients with ischemic left ventricular systolic dysfunction


Autoři: Damian Kaufmann aff001;  Małgorzata Szwoch aff001;  Joanna Kwiatkowska aff002;  Grzegorz Raczak aff001;  Ludmiła Daniłowicz-Szymanowicz aff001
Působiště autorů: Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk, Poland aff001;  Department of Pediatric Cardiology and Congenital Heart Defect, Medical University of Gdansk, Gdańsk, Poland aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225829

Souhrn

Background

Despite advancements in pharmacological and device-based treatment, heart failure (HF) continues to impose an enormous burden for health care system worldwide. Decompensation of HF is one of the main causes of hospitalization, therefore the identification of patients with the highest risk of such complication is still of great clinical importance. The prognostic significance and utility of global longitudinal strain (GLS) has been previously studied in patients with the broad spectrum of cardiovascular diseases in various endpoints, however its role in assessing the risk of hospitalization due to HF exacerbation of optimally treated outpatients has not been fully explored. Therefore, the aim of the study was to verify whether the GLS of the left ventricle (LV) derived by 2D speckle tracking echocardiography has, independently of other well-known clinical parameters, an additional impact on the risk of HF decompensation in stable patients with LV systolic dysfunction of ischemic origin.

Methods

In 193 clinically stable HF outpatients with LV ejection fraction (LVEF) ≤ 50%, GLS, additionally to other clinical parameters, was analyzed. During 34 (14–71) months of follow-up, 58 patients were hospitalized due to HF decompensation (EVENT).

Results

EVENT was significantly associated with age, QRS width, NYHA functional class, left atrium diameter, LV systolic and diastolic volume, LVEF, hemoglobin, brain natriuretic peptide, diuretic treatment, absence of beta-blockers, impaired renal function and history of diabetes in univariate Cox analyzes. GLS with pre-specified cut-off value of -9.4% was also significantly associated with the EVENT (HR 15.16; 95% CI 1.81–126.91). After adjusting for above-mentioned parameters GLS was still a significant predictor of hospitalization due to HF decompensation.

Conclusions

GLS measurement can provide incremental information on the risk of HF decompensation in stable outpatients with LV systolic dysfunction of ischemic origin.

Klíčová slova:

Cardiac atria – Diuretics – Echocardiography – Ejection fraction – Heart failure – Hemoglobin – Outpatients


Zdroje

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2019 Číslo 12