Global Longitudinal Strain Reference Values in the Hispanic/Latino Population: Echocardiographic Study of Latinos...

Global longitudinal strain (GLS) is a sensitive measure for detecting early cardiac dysfunction, but prone to variability by age, race/ethnicity, and sex. To date, GLS has not been described in Hispanics/Latinos, nor has GLS been associated with heart failure risk factors. Data from the Echocardiographic-Study of Latinos, a population-based study of Hispanics/Latinos in the United States, was used. A reference healthy sample was used to define the 95th-percentile lower limit of normal GLS value of -14.2% which was applied to the target population to describe the distribution of GLS across age, gender, and Hispanic/Latino background groups. The proportion of normal/abnormal GLS and left ventricular ejection fraction are described, as well as the proportion of abnormal GLS across prevalent heart failure risk factors (hypertension, obesity, and diabetes). Survey statistics and weighted frequencies were used in all analyses. The study sample consisted of 1,818 adult participants (mean age 56.4 years; 42.6% female). The overall ECHO-SOL target population had a mean GLS of -17.6% with 12.1% having prevalent abnormal GLS. GLS was significantly worse in men than women, and abnormal GLS was more prevalent among individuals of Cuban background than any other Hispanic/Latino background group. More than half (56.4%) of individuals with abnormal GLS had values within the normal left ventricular ejection fraction range, and there were worsening GLS values with increasing heart failure risk factor burden (p < 0.01). In conclusion, our study establishes the first Hispanic/Latino-specific GLS reference values, emphasizing the importance of representative populations in the derivation of myocardial deformation thresholds. Abnormal GLS was prevalent among Hispanics/Latinos, and increasing heart failure risk factor burden correlated with worsening GLS, reinforcing the role of risk factors in early cardiovascular risk assessment.