Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation
Evaluation of left ventricular global longitudinal strain (LVGLS) has allowed better characterization than left ventricular ejection fraction (LVEF) of subtle differences in left ventricular performance. The aim of this study was to determine whether LVGLS has prognostic value in patients with sever...
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| Veröffentlicht in: | Journal of the American Society of Echocardiography 2022-09, Vol.35 (9), p.947-955.e7 |
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| creator | Lee, Sun-Hack Oh, Jin Kyung Lee, Seung-Ah Kang, Do-Yoon Lee, Sahmin Kim, Ho Jin Ahn, Jung-Min Kim, Joon Bum Park, Duk-Woo Song, Jong-Min Choo, Suk Jung Kang, Duk-Hyun Song, Jae-Kwan Park, Seung-Jung Choi, Jung Hyun Kim, Dae-Hee |
| description | Evaluation of left ventricular global longitudinal strain (LVGLS) has allowed better characterization than left ventricular ejection fraction (LVEF) of subtle differences in left ventricular performance. The aim of this study was to determine whether LVGLS has prognostic value in patients with severe aortic stenosis and preserved LVEF undergoing transcatheter aortic valve implantation (TAVI).
Among 412 consecutive patients who underwent TAVI, 344 patients (mean age, 78.9 ± 5.0 years; 161 men) with preserved LVEF (≥50%) at baseline were analyzed. Patients with low LVEF (−16%, which was the first LVGLS quartile (cutoff value, −16%). The estimated actuarial 5-year survival rate was 81.7 ± 4.2% in the normal LVGLS group and 66.8 ± 7.5% in the impaired LVGLS group (P = .005). In the multivariable analysis, impaired LVGLS was an independent predictor of all-cause death (adjusted hazard ratio, 2.26; 95% CI, 1.11–4.60) and the composite outcome (adjusted hazard ratio, 3.03; 95% CI, 1.45–6.33). Moreover, the impaired LVGLS group had a poor prognosis, similar to the impaired LVEF group ( |
| doi_str_mv | 10.1016/j.echo.2022.04.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2659605798</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0894731722002310</els_id><sourcerecordid>2659605798</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-2fa97a885b54d7430c2875057f4bda0fd6226fd00e3d4d54ee12c06f9c9f7f873</originalsourceid><addsrcrecordid>eNp9kVFr2zAUhc3YWNNuf2APQ497sXctW5YNeyml7QKBFdb2VSjSVaJgS5kkp-w37U9OIVkfBwJJ6DuHo3uK4lMNVQ1193VXodr6igKlFbQV1M2bYlHDwMuOD-xtsYB-aEve1PyiuIxxBwCsB3hfXDSMQcsoXxR_lk4FnNAlOZKH4DfOx2QVeZbjjMQbskKTyHN-D1bNowzkfvTrzK6829g0a-vy5WcK0jqS14NMNsORvNi0zYYYMRxQk9sdqmS9I3dBng5PTmPYeOs25DFIF5VMW0wYyLUP5wQHJMtpP8oc7ij5ULwzcoz48bxfFU93t48338vVj_vlzfWqVA3rUkmNHLjse7ZmreZtA4r2nAHjpl1rCUZ3lHZGA2CjW81axJoq6MygBsNNz5ur4svJdx_8rxljEpONCsccBP0cBe3Y0GW_oc8oPaEq-BgDGrEPdpLht6hBHEsSO3EsSRxLEtCKXFIWfT77z-sJ9avkXysZ-HYCMP_yYDGIqPJUFWob8hiF9vZ__n8BwhqnRQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2659605798</pqid></control><display><type>article</type><title>Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation</title><source>Elsevier ScienceDirect Journals</source><creator>Lee, Sun-Hack ; Oh, Jin Kyung ; Lee, Seung-Ah ; Kang, Do-Yoon ; Lee, Sahmin ; Kim, Ho Jin ; Ahn, Jung-Min ; Kim, Joon Bum ; Park, Duk-Woo ; Song, Jong-Min ; Choo, Suk Jung ; Kang, Duk-Hyun ; Song, Jae-Kwan ; Park, Seung-Jung ; Choi, Jung Hyun ; Kim, Dae-Hee</creator><creatorcontrib>Lee, Sun-Hack ; Oh, Jin Kyung ; Lee, Seung-Ah ; Kang, Do-Yoon ; Lee, Sahmin ; Kim, Ho Jin ; Ahn, Jung-Min ; Kim, Joon Bum ; Park, Duk-Woo ; Song, Jong-Min ; Choo, Suk Jung ; Kang, Duk-Hyun ; Song, Jae-Kwan ; Park, Seung-Jung ; Choi, Jung Hyun ; Kim, Dae-Hee</creatorcontrib><description>Evaluation of left ventricular global longitudinal strain (LVGLS) has allowed better characterization than left ventricular ejection fraction (LVEF) of subtle differences in left ventricular performance. The aim of this study was to determine whether LVGLS has prognostic value in patients with severe aortic stenosis and preserved LVEF undergoing transcatheter aortic valve implantation (TAVI).
Among 412 consecutive patients who underwent TAVI, 344 patients (mean age, 78.9 ± 5.0 years; 161 men) with preserved LVEF (≥50%) at baseline were analyzed. Patients with low LVEF (<50%) were used as a comparison group in the survival analysis. The primary and secondary end points were all-cause death and a composite of cardiovascular death and heart failure hospitalization, respectively.
The mean LVGLS and LVEF were −17.1 ± 2.7% and 63 ± 5%, respectively. Impaired LVGLS was defined as >−16%, which was the first LVGLS quartile (cutoff value, −16%). The estimated actuarial 5-year survival rate was 81.7 ± 4.2% in the normal LVGLS group and 66.8 ± 7.5% in the impaired LVGLS group (P = .005). In the multivariable analysis, impaired LVGLS was an independent predictor of all-cause death (adjusted hazard ratio, 2.26; 95% CI, 1.11–4.60) and the composite outcome (adjusted hazard ratio, 3.03; 95% CI, 1.45–6.33). Moreover, the impaired LVGLS group had a poor prognosis, similar to the impaired LVEF group (<50%). The addition of the absolute value of LVGLS to the clinical parameters and LVEF led to significant improvement in the prediction of all-cause mortality.
In patients with severe aortic stenosis and preserved LVEF undergoing TAVI, subclinical LV dysfunction defined by impaired LVGLS is independently associated with poor clinical outcomes. LVGLS measurement provides incremental prognostic value above the established clinical and echocardiographic parameters.
•Prognostic value of LVGLS in TAVI patients with preserved LVEF was assessed.•Impaired preprocedural LVGLS was associated with poor outcome after TAVI.•In patients with preserved LVEF, impaired LVGLS had poor long-term outcomes.•The mortality rate with impaired LVGLS is similar to that with reduced LVEF.•LVGLS has incremental prognostic value to clinical parameters and LVEF.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2022.04.013</identifier><identifier>PMID: 35504527</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Global longitudinal strain ; Outcomes ; Transcatheter aortic valve implantation</subject><ispartof>Journal of the American Society of Echocardiography, 2022-09, Vol.35 (9), p.947-955.e7</ispartof><rights>2022 American Society of Echocardiography</rights><rights>Copyright © 2022 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-2fa97a885b54d7430c2875057f4bda0fd6226fd00e3d4d54ee12c06f9c9f7f873</citedby><cites>FETCH-LOGICAL-c356t-2fa97a885b54d7430c2875057f4bda0fd6226fd00e3d4d54ee12c06f9c9f7f873</cites><orcidid>0000-0002-8275-4871</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0894731722002310$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35504527$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Sun-Hack</creatorcontrib><creatorcontrib>Oh, Jin Kyung</creatorcontrib><creatorcontrib>Lee, Seung-Ah</creatorcontrib><creatorcontrib>Kang, Do-Yoon</creatorcontrib><creatorcontrib>Lee, Sahmin</creatorcontrib><creatorcontrib>Kim, Ho Jin</creatorcontrib><creatorcontrib>Ahn, Jung-Min</creatorcontrib><creatorcontrib>Kim, Joon Bum</creatorcontrib><creatorcontrib>Park, Duk-Woo</creatorcontrib><creatorcontrib>Song, Jong-Min</creatorcontrib><creatorcontrib>Choo, Suk Jung</creatorcontrib><creatorcontrib>Kang, Duk-Hyun</creatorcontrib><creatorcontrib>Song, Jae-Kwan</creatorcontrib><creatorcontrib>Park, Seung-Jung</creatorcontrib><creatorcontrib>Choi, Jung Hyun</creatorcontrib><creatorcontrib>Kim, Dae-Hee</creatorcontrib><title>Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Evaluation of left ventricular global longitudinal strain (LVGLS) has allowed better characterization than left ventricular ejection fraction (LVEF) of subtle differences in left ventricular performance. The aim of this study was to determine whether LVGLS has prognostic value in patients with severe aortic stenosis and preserved LVEF undergoing transcatheter aortic valve implantation (TAVI).
Among 412 consecutive patients who underwent TAVI, 344 patients (mean age, 78.9 ± 5.0 years; 161 men) with preserved LVEF (≥50%) at baseline were analyzed. Patients with low LVEF (<50%) were used as a comparison group in the survival analysis. The primary and secondary end points were all-cause death and a composite of cardiovascular death and heart failure hospitalization, respectively.
The mean LVGLS and LVEF were −17.1 ± 2.7% and 63 ± 5%, respectively. Impaired LVGLS was defined as >−16%, which was the first LVGLS quartile (cutoff value, −16%). The estimated actuarial 5-year survival rate was 81.7 ± 4.2% in the normal LVGLS group and 66.8 ± 7.5% in the impaired LVGLS group (P = .005). In the multivariable analysis, impaired LVGLS was an independent predictor of all-cause death (adjusted hazard ratio, 2.26; 95% CI, 1.11–4.60) and the composite outcome (adjusted hazard ratio, 3.03; 95% CI, 1.45–6.33). Moreover, the impaired LVGLS group had a poor prognosis, similar to the impaired LVEF group (<50%). The addition of the absolute value of LVGLS to the clinical parameters and LVEF led to significant improvement in the prediction of all-cause mortality.
In patients with severe aortic stenosis and preserved LVEF undergoing TAVI, subclinical LV dysfunction defined by impaired LVGLS is independently associated with poor clinical outcomes. LVGLS measurement provides incremental prognostic value above the established clinical and echocardiographic parameters.
•Prognostic value of LVGLS in TAVI patients with preserved LVEF was assessed.•Impaired preprocedural LVGLS was associated with poor outcome after TAVI.•In patients with preserved LVEF, impaired LVGLS had poor long-term outcomes.•The mortality rate with impaired LVGLS is similar to that with reduced LVEF.•LVGLS has incremental prognostic value to clinical parameters and LVEF.</description><subject>Global longitudinal strain</subject><subject>Outcomes</subject><subject>Transcatheter aortic valve implantation</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kVFr2zAUhc3YWNNuf2APQ497sXctW5YNeyml7QKBFdb2VSjSVaJgS5kkp-w37U9OIVkfBwJJ6DuHo3uK4lMNVQ1193VXodr6igKlFbQV1M2bYlHDwMuOD-xtsYB-aEve1PyiuIxxBwCsB3hfXDSMQcsoXxR_lk4FnNAlOZKH4DfOx2QVeZbjjMQbskKTyHN-D1bNowzkfvTrzK6829g0a-vy5WcK0jqS14NMNsORvNi0zYYYMRxQk9sdqmS9I3dBng5PTmPYeOs25DFIF5VMW0wYyLUP5wQHJMtpP8oc7ij5ULwzcoz48bxfFU93t48338vVj_vlzfWqVA3rUkmNHLjse7ZmreZtA4r2nAHjpl1rCUZ3lHZGA2CjW81axJoq6MygBsNNz5ur4svJdx_8rxljEpONCsccBP0cBe3Y0GW_oc8oPaEq-BgDGrEPdpLht6hBHEsSO3EsSRxLEtCKXFIWfT77z-sJ9avkXysZ-HYCMP_yYDGIqPJUFWob8hiF9vZ__n8BwhqnRQ</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Lee, Sun-Hack</creator><creator>Oh, Jin Kyung</creator><creator>Lee, Seung-Ah</creator><creator>Kang, Do-Yoon</creator><creator>Lee, Sahmin</creator><creator>Kim, Ho Jin</creator><creator>Ahn, Jung-Min</creator><creator>Kim, Joon Bum</creator><creator>Park, Duk-Woo</creator><creator>Song, Jong-Min</creator><creator>Choo, Suk Jung</creator><creator>Kang, Duk-Hyun</creator><creator>Song, Jae-Kwan</creator><creator>Park, Seung-Jung</creator><creator>Choi, Jung Hyun</creator><creator>Kim, Dae-Hee</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8275-4871</orcidid></search><sort><creationdate>20220901</creationdate><title>Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation</title><author>Lee, Sun-Hack ; Oh, Jin Kyung ; Lee, Seung-Ah ; Kang, Do-Yoon ; Lee, Sahmin ; Kim, Ho Jin ; Ahn, Jung-Min ; Kim, Joon Bum ; Park, Duk-Woo ; Song, Jong-Min ; Choo, Suk Jung ; Kang, Duk-Hyun ; Song, Jae-Kwan ; Park, Seung-Jung ; Choi, Jung Hyun ; Kim, Dae-Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-2fa97a885b54d7430c2875057f4bda0fd6226fd00e3d4d54ee12c06f9c9f7f873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Global longitudinal strain</topic><topic>Outcomes</topic><topic>Transcatheter aortic valve implantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Sun-Hack</creatorcontrib><creatorcontrib>Oh, Jin Kyung</creatorcontrib><creatorcontrib>Lee, Seung-Ah</creatorcontrib><creatorcontrib>Kang, Do-Yoon</creatorcontrib><creatorcontrib>Lee, Sahmin</creatorcontrib><creatorcontrib>Kim, Ho Jin</creatorcontrib><creatorcontrib>Ahn, Jung-Min</creatorcontrib><creatorcontrib>Kim, Joon Bum</creatorcontrib><creatorcontrib>Park, Duk-Woo</creatorcontrib><creatorcontrib>Song, Jong-Min</creatorcontrib><creatorcontrib>Choo, Suk Jung</creatorcontrib><creatorcontrib>Kang, Duk-Hyun</creatorcontrib><creatorcontrib>Song, Jae-Kwan</creatorcontrib><creatorcontrib>Park, Seung-Jung</creatorcontrib><creatorcontrib>Choi, Jung Hyun</creatorcontrib><creatorcontrib>Kim, Dae-Hee</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Sun-Hack</au><au>Oh, Jin Kyung</au><au>Lee, Seung-Ah</au><au>Kang, Do-Yoon</au><au>Lee, Sahmin</au><au>Kim, Ho Jin</au><au>Ahn, Jung-Min</au><au>Kim, Joon Bum</au><au>Park, Duk-Woo</au><au>Song, Jong-Min</au><au>Choo, Suk Jung</au><au>Kang, Duk-Hyun</au><au>Song, Jae-Kwan</au><au>Park, Seung-Jung</au><au>Choi, Jung Hyun</au><au>Kim, Dae-Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>35</volume><issue>9</issue><spage>947</spage><epage>955.e7</epage><pages>947-955.e7</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Evaluation of left ventricular global longitudinal strain (LVGLS) has allowed better characterization than left ventricular ejection fraction (LVEF) of subtle differences in left ventricular performance. The aim of this study was to determine whether LVGLS has prognostic value in patients with severe aortic stenosis and preserved LVEF undergoing transcatheter aortic valve implantation (TAVI).
Among 412 consecutive patients who underwent TAVI, 344 patients (mean age, 78.9 ± 5.0 years; 161 men) with preserved LVEF (≥50%) at baseline were analyzed. Patients with low LVEF (<50%) were used as a comparison group in the survival analysis. The primary and secondary end points were all-cause death and a composite of cardiovascular death and heart failure hospitalization, respectively.
The mean LVGLS and LVEF were −17.1 ± 2.7% and 63 ± 5%, respectively. Impaired LVGLS was defined as >−16%, which was the first LVGLS quartile (cutoff value, −16%). The estimated actuarial 5-year survival rate was 81.7 ± 4.2% in the normal LVGLS group and 66.8 ± 7.5% in the impaired LVGLS group (P = .005). In the multivariable analysis, impaired LVGLS was an independent predictor of all-cause death (adjusted hazard ratio, 2.26; 95% CI, 1.11–4.60) and the composite outcome (adjusted hazard ratio, 3.03; 95% CI, 1.45–6.33). Moreover, the impaired LVGLS group had a poor prognosis, similar to the impaired LVEF group (<50%). The addition of the absolute value of LVGLS to the clinical parameters and LVEF led to significant improvement in the prediction of all-cause mortality.
In patients with severe aortic stenosis and preserved LVEF undergoing TAVI, subclinical LV dysfunction defined by impaired LVGLS is independently associated with poor clinical outcomes. LVGLS measurement provides incremental prognostic value above the established clinical and echocardiographic parameters.
•Prognostic value of LVGLS in TAVI patients with preserved LVEF was assessed.•Impaired preprocedural LVGLS was associated with poor outcome after TAVI.•In patients with preserved LVEF, impaired LVGLS had poor long-term outcomes.•The mortality rate with impaired LVGLS is similar to that with reduced LVEF.•LVGLS has incremental prognostic value to clinical parameters and LVEF.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35504527</pmid><doi>10.1016/j.echo.2022.04.013</doi><orcidid>https://orcid.org/0000-0002-8275-4871</orcidid></addata></record> |
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| source | Elsevier ScienceDirect Journals |
| subjects | Global longitudinal strain Outcomes Transcatheter aortic valve implantation |
| title | Incremental Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients with Preserved Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation |
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