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Date Published: 16/02/2023
Online Published: 16/02/2023
Abstract Views: 192
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DOI: https://doi.org/10.55046/vjrnm.48.787.2022
Issue
No. 02 (2022): English
Section
Scientific research
How to Cite
Nguyen , T. T. H., Pham, V. T., Tran, L. N. ., Ngo, H. T. ., Luu, D. B. ., & Hoang, H. T. . (2023). Myocardial Strain to Predict Mid-term Mortality and Re-hospitalization in Patients With
Heart Failure and Reduced Ejection Fraction. Vietnamese Journal of Radiology and Nuclear Medicine, 02, 30-35. https://doi.org/10.55046/vjrnm.48.787.2022

Myocardial Strain to Predict Mid-term Mortality and Re-hospitalization in Patients With
Heart Failure and Reduced Ejection Fraction

TS.BS. Nguyễn Thị Thu Hoài, Viet Tuan Pham1, Lan Ngoc Tran1, Huong Thi Ngo1, Dao Bich Luu1, Hoa Thi Hoang2
1 Vietnam National Heart Institute, Bach Mai Hospital.
2 Hanoi Medical University.

Main Article Content

Abstract

Background: Heart failure (HF) is a severe clinical syndrome caused by diversed etiologies. Classically left ventricle ejection fraction (LVEF) has been used as a diagnostic marker as well as to subdivide HF into 3 groups (HFpEF, HFmEF and HFrEF). However, the prognostic value of this index is not consistent in comparison to LV strain (GLS, GCS) which are not only able to detect heart failure at a very early stage (precede to EF change) but also to predict the primary outcome including HF readmission and death. The prognostic role of LV strain is independent and incremental to conventional echocardiographic parameters.


Methods: 67 patients diagnosed with chronic HFrEF (EF < 40%) in Vietnam National Heart Institute were consecutively enrolled in our study from January 2016 to September 2016. Clinical data were comprehensively evaluated and conventional echocardiographic parameters and two LV strain indices (GLS & GCS) were measured using speckle-tracking. All patients were followed-up for all-cause 12-month readmission or death after discharge. The relation between echocardiographic parameters and clinical events was analyzed in Cox proportional hazard model.


Results: GLS had a prognostic value of composite events after being adjusted with age, sex, heart rate, SBP, DBP, NT-ProBNP, renal clearance, LVEF and LVDd. GLS (cut-off = -7.5%; AUC = 0.738; p = 0.003) was a stronger predictor of composite event compared to LVEF (AUC= 0.66, p = 0.042) LVDd (AUC = 0.637; p = 0.025), LA diameter (AUC = 0.614, p = 0.03), NT-ProBNP (AUC = 0.663; p = 0.04) and hs-Troponin T (AUC = 0.592; p = 0.039).


Conclusion:  Global longitudinal strain is and strong and independent predictor of readmission and death in patients with heart failure with reduced ejection fraction.

Article Details

Keywords

heart failure, left ventricular function, global longitudinal strain, ejection fraction

References

1. Murphy, N.F., et al., National survey of the prevalence, incidence, primary care burden, and treatment of heart failure in Scotland. Heart, 2004. 90(10): p. 1129-36.
2. Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC [Published correction appears in Eur Heart J 2016;39:860]. Eur J Heart Fail 2016;18:891–975
3. Curtis JP, Sokol SI, Wang Y, et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol 2003;42:736–42.
4. Mondillo, S., et al., Speckle-tracking echocardiography: a new technique for assessing myocardial function. J Ultrasound Med, 2011. 30(1): p. 71-83.
5. Yingchoncharoen, T., et al., Normal ranges of left ventricular strain: a meta-analysis. J Am Soc Echocardiogr, 2013. 26(2): p. 185-91.
6. Saito, M., et al., Association of left ventricular strain with 30-day mortality and readmission in patients with heart failure. J Am Soc Echocardiogr, 2015. 28(6): p. 652-66.
7. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1–39.
8. Laurens F. Tops, Victoria Delgado, Nina Ajmone Marsan, and Jeroen J. Bax. Myocardial strain to detect subtle left ventricular systolic dysfunction. European Journal of Heart Failure (2017)19, 307–313
9. Eek, C., et al., Strain echocardiography predicts acute coronary occlusion in patients with non-ST-segment elevation acute coronary syndrome. Eur J Echocardiogr, 2010. 11(6): p. 501-8. 10. Rev Port Cardiol. Rangel I1, G.A., de Sousa C3, Almeida PB3, Rodrigues J2, Macedo F3, Silva Cardoso J3, Maciel MJ4., Global longitudinal strain as a potential prognostic marker in patients with chronic heart failure and systolic dysfunction. 2014: p. 33(7-8):403-9. doi: 10.1016/j.repc.2014.01.023.
11. Cho GY, Marwick TH, Kim HS, Kim MK, Hong KS, Oh DJ. Global 2-dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol 2009;54:618–24.