Heart failure & cardiomyopathies
Predictive Value of Global Longitudinal Strain by Left Ventricular Ejection Fraction
Authors' conclusion
In this MADIT-CRT sub-study, LV GLS identified patients at higher risk of VT/VF, HF/death risk independently of conventional clinical parameters in patients with LVEF ≤ 30%, but not in patients with LVEF > 30%.
Study context
- Population
- Heart failure (HF) patients in MADIT-CRT with 2D speckle tracking data available59% with speckle tracking data
- Participants
- 1,077 patients
- Comparison
- Left ventricular (LV) global longitudinal strain (GLS) tertiles by left ventricular ejection fraction (LVEF) subgroup
- LVEF ≤ 30%n = 640
- LVEF > 30%n = 437
- Primary endpoint
- VT/VF or death
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
VT/VF or death, by LVEF subgroup
T1 vs T2/3Hazard ratio (CI)P value
LVEF ≤ 30%, multivariable
1.67(1.16–2.38)
P = 0.005LVEF > 30%, multivariable
1.32(0.86–2.04)
P = 0.21- Higher GLS tertile (T3, less contractility) associated with higher rate of VT/VF/death, LVEF ≤ 30%
- P < 0.001
- Similar association, LVEF > 30%
- P = 0.057
Secondary outcomes
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| HF or death, by LVEF subgroupT1vs T2/3LVEF ≤ 30% | 2.00 (1.30–3.13) | P = 0.002 | |
| 0.20.5125Hazard ratio (log scale) |
HF or death, by LVEF subgroup
- Higher GLS tertile associated with higher rate of HF/death, LVEF ≤ 30%
- LV GLS did not predict HF/death, LVEF > 30%
Original publication
Predictive Value of Global Longitudinal Strain by Left Ventricular Ejection Fraction. ESC Heart Fail. Published 29 March 2023. doi:10.
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