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Updated: May 5, 2026
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Speckle-tracking global longitudinal strain predicts death and cardiovascular events in patients with systemic
Giulia Stronati1, Federico Guerra1, Devis Benfaremo2
1Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Marche University Hospital, Via Conca 71, Ancona 60126, Italy.
Insights
Global longitudinal strain (GLS) in systemic sclerosis (SSc) predicts mortality and hospitalizations. Impaired biventricular GLS significantly increases the risk of death and hospital admission in SSc patients.
Area of Science:
- Cardiology
- Rheumatology
- Medical Imaging
Background:
- Heart involvement in systemic sclerosis (SSc) is a significant predictor of mortality.
- Global longitudinal strain (GLS) can detect subclinical cardiac dysfunction in SSc patients.
- The prognostic value of GLS in SSc clinical outcomes requires further investigation.
Purpose of the Study:
- To assess the association between left and right GLS and all-cause mortality in SSc patients.
- To evaluate the association between left and right GLS and hospitalization rates in SSc patients.
- To determine if GLS serves as a reliable prognostic tool for SSc patients.
Main Methods:
- Prospective longitudinal study of 164 SSc patients without pre-existing cardiac disease.
- Measurement of left and right ventricular GLS at enrollment.
- Follow-up for mortality and hospitalization events over a median of 3 years.
Main Results:
- Biventricular GLS impairment was independently associated with increased all-cause mortality and hospitalization.
- Patients with biventricular GLS impairment had a 4.2- to 13.9-fold increased risk of death compared to those with no or single-ventricle impairment.
- Hospitalization incidence was significantly higher in patients with biventricular GLS impairment.
Conclusions:
- Biventricular GLS is a reliable prognostic marker in SSc.
- GLS can predict mortality and hospitalization in SSc patients.
- GLS is a valuable tool for early detection and monitoring of cardiac involvement in SSc.
Aims:
Albeit often asymptomatic, heart involvement in systemic sclerosis (SSc) represents a negative prognostic factor, accounting for nearly one-fourth of all deaths. Global longitudinal strain (GLS) is accurate in detecting heart involvement in patients with SSc and no overt cardiac disease and allows early detection and longitudinal monitoring, but its association with clinical endpoints has not been tested so far. The primary outcome was the association between left and right GLS and mortality for all causes. The secondary outcome was the association between left and right GLS and hospitalizations.
Methods And Results:
A prospective longitudinal study enrolling all consecutive patients with SSc without structural heart disease or previous cardiovascular event.A total of 164 patients were enrolled, of whom 19 (11.5%) died during follow-up and 48 (29.3%) were hospitalized. Both left (LV) and right ventricle (RV) GLS at enrolment were independently associated with an increased risk of death for all causes and hospitalizations. Patients with biventricular GLS impairment, respectively, had a 4.2-, 4.9-, and 13.9-fold increased risk of death when compared with patients with only LV, only RV, or no impairment (P < 0.001). The incidence of hospitalization in patients with biventricular GLS impairment was nearly four times higher when compared with patients with only LV or only RV impairment, and nine times higher when compared with normal biventricular GLS (P < 0.001).
Conclusion:
Biventricular GLS is associated with an increased risk of death and hospitalization in patients with SSc during a median of 3-year follow-up, acting as a reliable and accurate prognostic tool in everyday practice.
