Layer‐specific global longitudinal strain and the risk of heart failure and cardiovascular mortality in the general population: the Copenhagen City Heart Study

Abstract

Layer-specific global longitudinal strain (GLS) has been demonstrated to predict outcome in various patient cohorts. However, little is known regarding the prognostic value of layer-specific GLS in the general population and whether different layers entail differential prognostic information. The aim of the present study was to investigate the prognostic value of whole wall (GLS WW ), endomyocardial (GLS Endo ), and epimyocardial (GLS Epi ) GLS in the general population.

Heart failure: an update from the last years and a look at the near future

“…Overall, 4013 citizens were included. Whole wall and epi‐myocardial global longitudinal strain (GLS) were found to be detrimental in differentiating between ischaemic and non‐ischaemic aetiology 64 to assess diastolic function 65 and to be significant predictors of outcome [a composite of incident HF or cardiovascular (CV) death] in males, whereas no GLS parameter was useful in females, 66 and also able to improve diagnosis. In a larger cohort of 117 275 subjects being followed up with echocardiography, even modest LVEF changes over time had a significant impact on prognosis with an increase from 12% to 29% of 5 year all‐cause mortality among subjects with the smallest to the largest decrease in LVEF (from <5 to >30 units) 67 .…”

November 2021 at a glance: focus on prevention, comorbidities, cardiogenic shock and novel devices

“…The Copenhagen City Heart Study investigated the prognostic value of whole wall, endomyocardial, and epimyocardial global longitudinal strain (GLS) in the general population. In the sex‐stratified analysis, whole wall and epimyocardial GLS were found to be significant predictors of prognosis in males, while no GLS parameter was useful in females 4 . Another study investigated the presence of subclinical congestion, assessed by three ultrasound (US) variables (inferior vena cava diameter, jugular vein distensibility ratio, the number of B‐lines from a 28‐point lung US), in patients with at least one risk factor for HF, including diabetes, ischaemic heart disease, and hypertension.…”

“…In the sex-stratified analysis, whole wall and epimyocardial GLS were found to be significant predictors of prognosis in males, while no GLS parameter was useful in females. 4 Another study investigated the presence of subclinical congestion, assessed by three ultrasound (US) variables (inferior vena cava diameter, jugular vein distensibility ratio, the number of B-lines from a 28-point lung US), in patients with at least one risk factor for HF, including diabetes, ischaemic heart disease, and hypertension. Subclinical congestion was common and was described in 30% of subjects.…”

Cardiac mechanics assessment and the risk of heart failure in the general population

“…In this issue of the Journal, Skaarup et al 13 . assess for the first time the prognostic value of overall GLS compared with layer‐specific strain measures in a large low‐risk general population free of prevalent HF from the fifth Copenhagen City Heart Study (4013 participants with a mean age of 56 years).…”

“…In this issue of the Journal, Skaarup et al 13 assess for the first time the prognostic value of overall GLS compared with layer-specific strain measures in a large low-risk general population free of prevalent HF from the fifth Copenhagen City Heart Study (4013 participants with a mean age of 56 years). The authors found that impairment of all the three strain measures, whole GLS and both endocardial strain (GLSendo) and epicardial strain (GLSepi), significantly increases the risk for incident HF or CV mortality by 15%, 10% and 18%, respectively, regardless of clinical confounders and LVEF.…”