Combined Left Ventricular and Left Atrial Strain Assessment for Long-Term Risk Stratification in Heart Failure With...

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Research

Background:

• Left ventricular global longitudinal strain (LV GLS) and left atrial reservoir strain (LASr) are known predictors of adverse outcomes in heart failure with reduced ejection fraction (HFrEF).
• The combined prognostic value of LV GLS and LASr in HFrEF patients has not been fully explored.

Purpose of the Study:

• To evaluate the prognostic significance of combined LV GLS and LASr assessment in patients hospitalized with decompensated HFrEF.
• To determine if combined strain parameters enhance risk stratification compared to individual measures.

Main Methods:

• Retrospective analysis of 341 HFrEF patients undergoing speckle-tracking echocardiography.
• Assessment of LV GLS and LASr, with ROC analysis to define optimal cutoff values (7.3% for GLS, 9.0% for LASr).
• Cox proportional hazards models used to assess association with all-cause mortality over a median 59-month follow-up.

Main Results:

• A total of 238 patients (70%) died during follow-up.
• Both LV GLS and LASr were independently associated with all-cause mortality after multivariable adjustment.
• Patients with impaired LV GLS and LASr had the highest mortality risk; those with least impairment had the best outcomes, indicating enhanced risk stratification.

Conclusions:

• Both LV GLS and LASr are independent predictors of mortality in HFrEF.
• Combined assessment of LV GLS and LASr provides enhanced risk stratification, identifying distinct risk phenotypes in HFrEF patients.