One-Month Global Longitudinal Strain Identifies Patients Who Will Develop Pacing-Induced Left Ventricular Dysfunction...

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Imaging

Background:

• Predicting left ventricular (LV) dysfunction after pacemaker implantation is challenging.
• LV global longitudinal strain (GLS) measured by 2D speckle tracking echocardiography may identify patients at risk.
• Investigating GLS for predicting pacing-induced left ventricular dysfunction (PIVD) or cardiomyopathy (PICMP).

Purpose of the Study:

• To determine if LV GLS can predict PIVD or PICMP.
• To assess the accuracy of GLS in identifying patients at risk for these conditions.

Main Methods:

• Fifty-five patients with atrioventricular block and preserved LV function received dual-chamber pacemakers.
• Serial echocardiography was performed for 12 months to monitor LV ejection fraction (LVEF).
• PIVD defined as LVEF reduction ≥5 points; PICMP defined as LVEF <45% at 12 months.

Main Results:

• 27% of patients developed PIVD, with 4 developing PICMP.
• One-month GLS was significantly lower in patients who developed PIVD (p=0.022).
• One-month GLS accurately predicted PIVD/PICMP development (AUC=0.80) and PICMP (AUC=0.86).

Conclusions:

• GLS is a novel predictor of declining LV systolic function post-pacemaker implantation.
• GLS identifies patients at risk for PIVD before LVEF changes are apparent.
• Early GLS measurement post-implantation accurately predicts subsequent PIVD or PICMP.