• Circ Cardiovasc Imaging · May 2012

    Global longitudinal strain predicts long-term survival in patients with chronic ischemic cardiomyopathy.

    • Matteo Bertini, Arnold C T Ng, M Louisa Antoni, Gaetano Nucifora, See H Ewe, Dominique Auger, Nina Ajmone Marsan, Martin J Schalij, Jeroen J Bax, and Victoria Delgado.
    • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
    • Circ Cardiovasc Imaging. 2012 May 1;5(3):383-91.

    BackgroundLeft ventricular (LV) global longitudinal strain (GLS) is a measure of the active shortening of the LV in the longitudinal direction, which can be assessed with speckle-tracking echocardiography. The aims of this evaluation were to validate the prognostic value of GLS as a new index of LV systolic function in a large cohort of patients with chronic ischemic cardiomyopathy and to determine the incremental value of GLS to predict long-term outcome over other strong and well-established prognostic factors.Methods And ResultsA total of 1060 patients underwent baseline clinical evaluation and transthoracic echocardiography. Median age was 66.9 years (interquartile range, 58.4, 74.2 years); 739 (70%) were men. The median follow-up duration for the entire patient population was 31 months. During the follow-up, 270 patients died and 309 patients reached the combined end point (all-cause mortality and heart failure hospitalization). Compared with survivors, patients who died (270, [25%]) had larger LV volumes (P<0.05), lower LV ejection fraction (P=0.004), higher wall motion score index (P=0.001), and greater impairment of LV GLS (P<0.001). After dichotomizing the population on the basis of the median value of LV GLS (-11.5%), patients with an LV GLS ≤-11.5% had superior outcome compared with patients with an LV GLS >-11.5% (log-rank χ(2), 13.86 and 14.16 for all-cause mortality and combined end point, respectively, P<0.001 for both). On multivariate analysis, GLS was independently related to all-cause mortality (hazard ratio per 5% increase, 1.69; 95% confidence interval, 1.33-2.15; P<0.001) and combined end point (1.64; 95% confidence interval, 1.32-2.04; P<0.001).ConclusionsThe assessment of LV GLS with speckle-tracking echocardiography is significantly related to long-term outcome in patients with chronic ischemic cardiomyopathy.

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