Prognostic implications of left ventricular global longitudinal strain in heart failure patients with narrow QRS complex treated with cardiac resynchronization therapy: a subanalysis of the randomized EchoCRT trial

Abstract

Bax, J. J. et al. (2017) Prognostic implications of left ventricular global longitudinal strain in heart failure patients with narrow QRS complex treated with cardiac resynchronization therapy: a subanalysis of the randomized EchoCRT trial. European Heart Journal, 38(10), pp. 720-726.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/139629/ patients in the CRT-OFF group and 111 in the CRT-ON group reached the combined primary endpoint of.all-cause mortality and heart failure hospitalization. Each 1% absolute unit decrease in LV GLS was independently associated with 11% increase in the risk to reach the primary endpoint (hazard ratio 1.11; 95% confidence interval 95% 1.04-1.17, P<0.001), after adjusting for ischemic cardiomyopathy and randomization treatment among other clinically relevant variables. When categorising patients according to quartiles of LV GLS, the primary endpoint occurred more frequently in patients in the lowest quartile (<6.2%) treated with CRT-ON versus CRT-OFF (45.6% versus 28.7%, P=0.009) whereas no differences were observed in patients with LV GLS ≥6.2% treated with CRT-OFF versus CRT-ON (23.7% versus 24.5%, respectively; P=0.62). Running title: LV GLS and CRT in narrow QRS Conclusion:Low LV GLS is associated with poor outcome in heart failure patients with QRS width <130 ms, independent of randomisation to CRT or not. Importantly, in the group of patients with the lowest LV GLS quartile, CRT may have a detrimental effect on clinical outcomes.3

Interim Analysis of the Phase II Study: Noninferiority Study of Doxorubicin with Upfront Dexrazoxane plus Olaratumab for Advanced or Metastatic Soft-Tissue Sarcoma

“…When possible, 3D echocardiograms were obtained, but these were not clinically feasible in a significant number of patients and were not used for clinical decision making. Myocardial strain imaging was obtained from the apical 4-chamber, 2-chamber, and long-axis views to determine global longitudinal strain (GLS), as described previously in detail (GE EchoPac v200, Horton, Norway) (17).…”

The year in cardiology 2017: heart failure

“…47 A recent study suggested that 17-34% of patients with HFrEF or HFmrEF improve to a higher category, and that this, as expected, was more common in the absence of ischaemic heart disease. 48 Other modalities may refine characterization of HF, such as global longitudinal strain, 49,50 but their impact in clinical routine remains to be seen. Given the heterogeneity of HF and difficulty characterizing HF, in particular with preserved EF, multimarker personalized approaches to HF, as occurs in oncology, may improve characterization and classification in HF.…”

Left ventricular global longitudinal strain in predicting CRT response: one more J-shaped curve in medicine

“…Echocardiographic strain by speckle-tracking precisely characterizes left ventricle performance [7], scar burden [8], and dyssynchrony [9]. Left ventricle global longitudinal strain (LVGLS) is associated with the outcome in general population [10] as well as in heart failure patients [11]. Previous studies have demonstrated that baseline left ventricle function stays in relation Michal Orszulak and Artur Filipecki contributed equally to this manuscript.…”