Abstract 17733: Association of Left Ventricular Longitudinal Strain With Cardiac Events in Dilated Cardiomyopathy Patients With Myocardial Fibrosis
INTRODUCTION: Myocardial fibrosis is associated with worse outcome in dilated cardiomyopathy (DCM) patients. Global strain in left ventricle (LV) is a sensitive measure of LV mechanics. However, it is not well established whether myocardial strain related with long-term adverse events in DCM patients with myocardial fibrosis. The aim of this study was to investigate the association of myocardial strain with long-term adverse events in DCM patients with myocardial fibrosis.
METHODS: We studied consecutive 130 DCM patients who were detected myocardial fibrosis as late gadolinium-enhancement (LGE) on cardiovascular magnetic resonance (CMR) (62±15 years, 85 males, LV ejection fraction (EF) 32±9 %, NYHA class I: n= 4; II: n=33; III: n=92; IV: n=1). All patients underwent echocardiography with conventional assessment including LV end-diastolic and end-systolic volume (LVEDV, LVESV) and LVEF, and with two-dimensional speckle-tracking analyses of global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS). Brain natriuretic peptide (BNP) was measured. Outcome was assessed according to death and hospitalization with heart failure in the follow-up period for 1227±771 days.
RESULTS: There were 6 cardiac deaths and 34 HF hospitalizations in the follow-up period. Using univariate analyses, GLS and NYHA functional class had a significant association with long-term outcome (all p<0.05), while LVEF, LVEDV, LVESV, BNP, GRS and GCS did not. Then, multivariate analysis demonstrated GLS was the only independent prognostic factor among them. Dividing all 130 patients into three groups (1st tertile: GLS< -9.4%, n =44; 2nd tertile: ≥ -9.4, < -5.4%, n = 43; 3rd tertile: ≥ -5.4%, n=43), Kaplan-Meier curve analysis showed DCM patients with higher GLS were associated with worse long-term outcome (P<0.01).
CONCLUSIONS: Left ventricular GLS is associated with long-term outcome and can be useful to stratify the risk in DCM patients with myocardial fibrosis.
- © 2013 by American Heart Association, Inc.