Feature-Tracking Global Longitudinal Strain Predicts Mortality in Patients With Preserved Ejection Fraction: A...

Area of Science:

• Cardiology
• Medical Imaging
• Cardiac Mechanics

Background:

• Ejection fraction is a primary clinical metric for cardiac function and prognosis.
• Subtle myocardial deformation abnormalities can exist despite preserved ejection fraction.
• Cardiac magnetic resonance (CMR) feature-tracking allows strain assessment from routine cine images.

Purpose of the Study:

• To evaluate the prognostic significance of global longitudinal strain (GLS) using CMR feature-tracking.
• To assess GLS in a large, multicenter cohort of patients with preserved ejection fraction.

Main Methods:

• Retrospective analysis of 1,274 patients with preserved ejection fraction (≥50%) undergoing CMR.
• Global longitudinal strain (GLS) calculated from 3 long-axis cine views using feature-tracking.
• Cox regression modeling used to determine the association between GLS and all-cause mortality.

Main Results:

• 115 deaths occurred during a median follow-up of 6.2 years.
• Lower GLS (< median -20%) was associated with significantly reduced event-free survival.
• Each 1% worsening in GLS increased mortality risk by 22.8% (HR: 1.228, p < 0.001), independent of other factors.

Conclusions:

• Global longitudinal strain (GLS) derived from CMR feature-tracking is a potent, independent predictor of mortality.
• GLS provides prognostic information incremental to established clinical and imaging risk factors in patients with preserved ejection fraction.