Role of global longitudinal strain in discriminating variant forms of left ventricular hypertrophy and predicting mortality

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Küçük Resim

Tarih

2021

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

Anatoljcardiol

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Objective: In this study, we aimed to compare the functional adaptations of the left ventricle in variant forms of left ventricular hypertrophy (LVH) and to evaluate the use of two-dimensional speckle tracking echocardiography (2D-STE) in differential diagnosis and prognosis. Methods: This was a prospective cohort study of 68 patients with LVH, including 20 patients with non-obstructive hypertrophic cardiomyopathy (HCM), 23 competitive top-level athletes free of cardiovascular disease, and 25 patients with hypertensive heart disease (HHD). All the subjects underwent 2D transthoracic echocardiography (TTE) and 2D-STE. The primary endpoint was all-cause mortality. Global longitudinal strain (GLS) below ?12.5% was defined as severely reduced strain, ?12.5% to ?17.9% as mildly reduced strain, and above ?18% as normal strain. Results: The mean LV-GLS value was higher in athletes than in patients with HCM and HHD with the lowest value being in the HCM group (HCM: ?11.4±2.2%; HHD: ?13.6±2.6%; and athletes: ?15.5±2.1%; p<0.001 among groups). LV-GLS below ?12.5% distinguished HCM from others with 65% sensitivity and 77% specificity [area under curve (AUC)=0.808, 95% confidence interval (CI): 0.699–0.917, p<0.001]. The median follow-up duration was 6.4±1.1 years. Overall, 11 patients (16%) died. Seven of these were in the HHD group, and four were in the HCM group. The mean GLS value in patients who died was ?11.8±1.5%. LV-GLS was significantly associated with mortality after adjusting age and sex via multiple analysis (RR=0.723, 95% CI: 0.537–0.974, p=0.033). Patients with GLS below ?12.5% had a higher risk of all-cause mortality compared with that of patients with GLS above ?12.5% according to Kaplan-Meier survival analysis for 7 years (29% vs. 9%; p=0.032). The LV-GLS value predicts mortality with 64% sensitivity and 70% specificity with a cut-off value of ?12.5 (AUC=0.740, 95% CI: 0.617-0.863, p=0.012). Conclusion: The 2D-STE provides important information about the longitudinal systolic function of the myocardium. It may enable differentiation variable forms of LVH and predict prognosis.

Açıklama

Anahtar Kelimeler

Left Ventricular Hypertrophy, Hypertension, Hypertrophic Cardiomyopathy, Athlete’s Heart, Speckle-tracking Echocardiography, Speckle-tracking Echocardiography

Kaynak

Anatol J Cardiol

WoS Q Değeri

Q4

Scopus Q Değeri

N/A

Cilt

25

Sayı

12

Künye

Karaca Özer, P., Ayduk Gövdeli, E., Engin, B., Atıcı, A., Baykız, D., Orta, H., Demirtakan, Z. G., Emet, S., Elitok, A., Tayyareci, Y., Umman, B., Bilge, A. K., & Buğra, Z. (2021). Role of global longitudinal strain in discriminating variant forms of left ventricular hypertrophy and predicting mortality. Anatolian journal of cardiology, 25(12), 863–871.