Objective: This study aimed to investigate the predictive value of left ventricular global longitudinal strain (GLS) and left atrial reservoir strain (LARS) on adverse events in chronic coronary artery disease (CAD) patients with reduced systolic function.Methods: A total of 192 consecutive patients clinically diagnosed with chronic CAD and left ventricular ejection fraction (LVEF) < 50% were finally included. Multiple strain parameters were analyzed with speckle tracking echocardiography. The composite endpoint included all-cause mortality, rehospitalization due to heart failure, myocardial infarction, and stroke.Results: Patients experiencing the endpoint showed lower LVEF, lower absolute GLS and LARS than those without events. Both GLS (AUC = 0.82 [GLS] vs. 0.58 [LVEF], p < 0.001) and LARS (AUC = 0.71 [LARS] vs. 0.58 [LVEF], p = 0.033) were superior to LVEF in predicting adverse events. Multivariate cox regression analysis showed that both GLS (hazard ratio, 0.71; 95% CI, 0.63-0.79; p < 0.001) and LARS (hazard ratio, 0.96; 95% CI, 0.93-0.98; p < 0.001) were independent predictors for the endpoint. The addition of LARS (global chi-squared, 35.7 vs. 17.4; p < 0.05), GLS (global chi-squared, 58.6 vs. 17.4; p < 0.05) or both LARS and GLS (global chi-squared, 79.6 vs. 17.4; p < 0.05) to LVEF in the prediction model significantly improved its performance. The same significant improvement was also shown in the subgroups of mild (30% < LVEF <= 50%) and severe (LVEF <= 30%) reduced systolic function.Conclusions: Regarding CAD patients with reduced LVEF, both GLS and LARS are superior to LVEF in predicting adverse events, providing significant incremental value to LVEF.
基金:
Dr Liu is supported by Cardiovascular Ultrasound Innovation Team of Yunnan Province in China [202305AS350021]; Cardiovascular Ultrasound Innovation Team of Yunnan Province in China
第一作者单位:[1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Med Ultrasound, Wuhan, Peoples R China
通讯作者:
通讯机构:[1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Med Ultrasound, Wuhan, Peoples R China[2]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Med Ultrasound, 1095 Jiefang Rd, Wuhan 430030, Peoples R China
推荐引用方式(GB/T 7714):
Lu Shi-Rui,Zhu Ying,Zhou Wei,et al.Incremental prognostic utility of left ventricular and left atrial strains in coronary artery disease patients with reduced systolic function[J].ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES.2024,41(1):doi:10.1111/echo.15740.
APA:
Lu, Shi-Rui,Zhu, Ying,Zhou, Wei,Zhang, Jun,Deng, You-Bin&Liu, Ya-Ni.(2024).Incremental prognostic utility of left ventricular and left atrial strains in coronary artery disease patients with reduced systolic function.ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES,41,(1)
MLA:
Lu, Shi-Rui,et al."Incremental prognostic utility of left ventricular and left atrial strains in coronary artery disease patients with reduced systolic function".ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES 41..1(2024)