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Global Longitudinal Strain and Left Atrial Volume Index Provide Incremental Prognostic Value in Patients With

Yasmine L Hiemstra1, Philippe Debonnaire1, Marianne Bootsma1

  • 1From the Departments of Cardiology (Y.L.H., P.D., M.B., V.D., M.J.S., D.E.A., J.J.B., N.A.M.) and Medical Statistics (E.W.v.Z.), Leiden University Medical Center, The Netherlands.

Circulation. Cardiovascular Imaging
|July 7, 2017
PubMed

Insights

Left ventricular global longitudinal strain (GLS) and left atrial volume index (LAVI) predict adverse events in hypertrophic cardiomyopathy patients. These novel echocardiographic measures improve risk stratification for better patient outcomes.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Disease

Background:

  • Current methods for predicting adverse events in hypertrophic cardiomyopathy (HCM) are limited.
  • Left ventricular global longitudinal strain (GLS) and left atrial volume index (LAVI) are emerging prognostic factors in cardiovascular diseases.

Purpose of the Study:

  • To evaluate the prognostic value of GLS and LAVI in patients diagnosed with hypertrophic cardiomyopathy.

Main Methods:

  • Two-dimensional echocardiography was performed in 427 HCM patients.
  • GLS and LAVI were assessed and correlated with adverse outcomes including mortality, heart transplantation, sudden cardiac death, and ICD therapy.

Main Results:

  • GLS and LAVI were independently associated with adverse outcomes in HCM patients (HR GLS: 1.10, HR LAVI: 4.27).
  • Patients with LAVI <34 mL/m² and GLS <-15% demonstrated significantly better survival.
  • Adding GLS and LAVI to clinical models improved risk prediction (C-statistic increased from 0.68 to 0.73).

Conclusions:

  • GLS and LAVI are independent predictors of adverse outcomes in hypertrophic cardiomyopathy.
  • These echocardiographic parameters can enhance risk stratification for HCM patients.
Abstract

Keywords:
cardiomyopathy, hypertrophicdeath, sudden, cardiacehocardiographyheart transplantationprognosis

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