Cardiovascular Non-Invasive Imaging Research Laboratory, Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.
Department of Cardiology, University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Int J Cardiovasc Imaging. 2021 Nov;37(11):3193-3202. doi: 10.1007/s10554-021-02296-y. Epub 2021 May 31.
Global Longitudinal Strain (GLS) is a well-established predictor of heart failure (HF) following acute coronary syndrome (ACS). We aim to investigate the prognostic value of GLS obtained at a follow-up consultation, as well as the change in GLS for long-term risk of incident HF. A total of 235 ACS patients had an echocardiogram performed immediately after percutaneous coronary intervention (PCI) and a follow-up echocardiogram (FUE) median 215 (IQR: 71; 878) days after the first echocardiogram. Endpoint was incident HF. Follow-up time after FUE was median 4.8 (IQR: 3.7; 5.6) years. Patients diagnosed with HF before FUE were excluded. Mean age was 63 ± 11 years and 77% were male. Baseline GLS was on average 12.7 ± 3.9%, FUE GLS was on average 13.5 ± 3.9% and mean improvement in GLS was 0.73 ± 3.68% between the 2 echocardiograms. A total of 57 (24%) patients suffered incident HF following the FUE. FUE GLS provided significantly higher prognostic information for risk of incident HF than ∆GLS when assessed by the C-statistics (C-statistics: 0.71 vs. 0.61, P = 0.021). Furthermore, after multivariable adjustments only FUE GLS [HR = 1.15, 95% CI (1.02; 1.29), P = 0.018, per 1% decrease] remained an independent predictor of incident HF. In patients with ACS, who do not develop HF before FUE, FUE GLS was an independent predictor of long-term risk of incident HF while ∆GLS was not.
全球应变(GLS)是急性冠脉综合征(ACS)后心力衰竭(HF)的一个既定预测因子。我们旨在研究随访时GLS 的预后价值，以及 GLS 的变化对 HF 事件的长期风险。共有 235 例 ACS 患者在经皮冠状动脉介入治疗(PCI)后立即进行超声心动图检查，并在第一次超声心动图后中位数 215(IQR:71;878)天进行随访超声心动图(FUE)。终点为 HF 事件。FUE 后随访时间中位数为 4.8(IQR:3.7;5.6)年。在 FUE 前被诊断为 HF 的患者被排除在外。平均年龄为 63±11 岁，77%为男性。基线 GLS 平均为 12.7±3.9%，FUE GLS 平均为 13.5±3.9%，两次超声心动图之间 GLS 的平均改善值为 0.73±3.68%。共有 57(24%)例患者在 FUE 后发生 HF 事件。FUE GLS 在评估风险的 C 统计量方面为 HF 事件提供了显著更高的预后信息，而 ∆GLS 则没有(C 统计量:0.71 对 0.61，P=0.021)。此外，在多变量调整后，只有 FUE GLS[HR=1.15，95%CI(1.02;1.29)，P=0.018，每降低 1%]仍然是 HF 事件的独立预测因子。在没有在 FUE 前发生 HF 的 ACS 患者中，FUE GLS 是 HF 事件长期风险的独立预测因子，而 ∆GLS 则不是。
