Abstract 420: Longitudinal Global Strain by Speckle Tracking is an Independent Predictor of Outcome in Patients With Impaired Left Ventricular Ejection Fraction
Objective: To assess the prognosis value of global longitudinal strain (ϵ) and ϵ rate by speckle tracking to predict outcome in patients with Impaired Left Ventricular Ejection Fraction.
Methods: The study included 125 consecutive patients (62.6±16.4 years, 77% male, 52% ischemia) with reduced left ventricular ejection fraction (LVEF<50%, mean =31±10%, range 10 – 49]. At inclusion, all patients underwent a complete echocardiography and clinical examination. Brain Natriuretic Peptide level (BNP) was assessed in 93 patients. Longitudinal global-ϵ and ϵ rate by speckle tracking were computed from apical views (4, 3, 2C) and compared to the occurrence of major cardiac events (death, heart transplantation, and recurrent HF).
Results: On the whole, peak systolic longitudinal global-ϵ and ϵ rate averaged −8± 3% [range −3 to −18] and −0.33±0.16s−1 [range −0.825 to −0.05], respectively. During the follow up period (266±177 days), major cardiac adverse events occurred in 52 (42.3%) patients (14 death, 32 recurrent HF and 4 heart transplantation). Univariable analysis using Cox model shown that global-ϵ, ϵ rate, LVEF, tricuspid annular plane systolic excursion, NYHA class and BNP level were associated with cardiac adverse event. However, only global-ϵ and BNP level were predictive of outcome by multivariable analysis. Importantly, in patients with global strain >−8% the risk of major cardiac events during the follow up was increased by 4.2 (p<0.0001, See Figure⇓).
Conclusion: In patients with impaired Left Ventricular Ejection Fraction, peak global strain by speckle tracking appears to be the only echocardiography predictor of adverse outcome.