Abstract 17007: Global Longitudinal Strain as a Prognostic Marker: A Systematic Review and Meta-Analysis in 7474 Patients
Background: Global Longitudinal Strain (GLS) is a novel parameter to measure LV longitudinal deformation, which is robust, well-validated and reproducible. GLS accurately identifies early changes in a variety of myocardial diseases. The aim of this study was to systematically review the evidence of prognostic value of GLS.
Methods: We searched Pubmed for prospective (Pr) and retrospective(Rr) observational studies where GLS was compared to LVEF and WMSI in different cardiac pathologies. A composite outcome was selected comprising cardiac mortality, and hospitalization secondary to heart failure or malignant arrhythmias. A random effect model was used to combine hazard ratio (HR) and 95% confidence intervals (CIs). The results were adjusted for significant co-variates.
Results: Data were collated from 22 published articles (n=7474 adult patients) comprising 19 Pr and 3 Rr observational studies. The underlying cardiac conditions were heart failure, acute myocardial infarction (AMI), valvular heart diseases (aortic stenosis and mitral regurgitation), repaired tetralogy of Fallot and cardiac amyloidosis. There were 2179 cardiac events. GLS (HR 1.21 [95% CI 1.12-1.30], p=<0.00001, Z= 5.05) and LVEF (HR=0.99 [95% CI 0.96-1.02], p<0.00001, Z=0.73) were predictive of cardiac outcome
Conclusion: There is strong evidence of the prognostic value of GLS, which appears to have at least analogous prognostic value to EF for predicting major cardiovascular events.
- © 2013 by American Heart Association, Inc.