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Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy

Minna Moreira Dias Romano1, Henrique Turin Moreira1, Fawaz Alenezi2

  • 1Cardiology Center of the Medical School of Ribeirao Preto, University of São Paulo (USP), São Paulo, Brazil.

Plos Neglected Tropical Diseases
|August 6, 2025
PubMed

Insights

Global longitudinal strain (GLS) predicts cardiovascular events in Chronic Chagas cardiomyopathy (CCC). This finding offers a new tool for risk stratification in Chagas disease patients, independent of ejection fraction.

Area of Science:

  • Cardiology
  • Echocardiography
  • Medical Diagnostics

Background:

  • Chronic Chagas cardiomyopathy (CCC) significantly increases cardiovascular event risk.
  • Global longitudinal strain (GLS) shows prognostic value in various cardiomyopathies.
  • The predictive capability of GLS in CCC requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic significance of GLS in patients with CCC.
  • To determine if GLS can predict adverse cardiovascular outcomes in CCC.
  • To assess the utility of GLS for risk stratification in Chagas disease.

Main Methods:

  • Retrospective echocardiography analysis with prospective follow-up.
  • GLS measured using vendor-independent software from LV apical peak longitudinal strain.
  • GLS categorized into tertiles for prognostic comparison.

Main Results:

  • GLS was assessed in 77 CCC patients (mean age 56 ± 15 years).
  • After 35 ± 19 months, 33 patients experienced composite adverse outcomes.
  • Higher GLS values (≥ -13.8%) were significantly associated with worse prognosis (log rank p=0.001).
  • Multivariate analysis confirmed GLS as an independent predictor of outcomes (HR 1.20, p=0.008), adjusted for age, gender, and LVEF.

Conclusions:

  • Left ventricle GLS independently predicts cardiovascular outcomes in CCC patients.
  • GLS serves as a valuable tool for risk stratification in Chagas disease, irrespective of LVEF.
Abstract

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