Heart failure & cardiomyopathies
Discriminative Ability of Left Ventricular Strain in Mildly Reduced Ejection Fraction Heart Failure
Main finding · Overall survival discriminationResult — go to the resultCategory-free net reclassification index 0.44Authors' conclusion
Among HFmrEF patients, LV strain may serve as an attractive systolic marker and provide a better prognostic and therapeutic discriminative measure for ARNi treatment than conventional LVEF.
Study context
- Population
- First-time hospitalized patients with HF with mildly reduced EF (heart failure with mildly reduced ejection fraction (HFmrEF))
- Participants
- 1,075 participants
- Exposure
- Left ventricular (LV) strain vs LV ejection fraction (LVEF) for prognostic and ARNI-response discrimination
- Outcome
- Overall survival discrimination
Main finding
As reported in the abstract
Category-free net reclassification index
0.44
P < 0.001
By group
MAGGIC-LV strain
0.71
Harrell's C-index
MAGGIC-LVEF
0.56
Harrell's C-index
- LV strain inversely associated with MAGGIC cardiac risk (coefficient)
- −0.14
Observational data: associations, not effects.
Further findings
ARNI vs renin-angiotensin system inhibitor effect by baseline LV strain or LVEF
- Lower LV strain but not LVEF consistently showed beneficial effects of ARNI vs renin-angiotensin system inhibitor
- all P interaction <0.05
- Cox models and restrictive cubic spline
Original publication
Discriminative Ability of Left Ventricular Strain in Mildly Reduced Ejection Fraction Heart Failure. JACC Adv. Published 24 November 2023. doi:10.
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