Heart failure & cardiomyopathies
Prognostic Value of LV Global Longitudinal Strain by 2D and 3D Speckle-Tracking Echocardiography in Patients With Heart Failure with Preserved Ejection Fraction (HFpEF)
Authors' conclusion
LV 2D-GLS and 3D-GLS are impaired in patients with HFpEF and T2D, and are independent predictors of adverse outcomes. Moreover, 3D-GLS provides incremental prognostic value over 2D-GLS.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF), with and without type 2 diabetes (T2D)patients with HFpEF prospectively enrolled
- Participants
- 335 patients
- Exposure
- HFpEF and T2D vs without T2D
Main finding
As reported in the abstract
LV 2D-GLS and 3D-GLS
- LV 2D-GLS and 3D-GLS were impaired in patients with HFpEF and T2D compared with those without T2D
Observational data: associations, not effects.
Further findings
| Outcome | 3D-GLS model | 2D-GLS model | LV ejection fraction model | ΔC-index | P value |
|---|---|---|---|---|---|
| Model predictive accuracy — 3D-GLS model vs 2D-GLS model | 0.056 | P = 0.034 | |||
| Akaike information criterion | −583.9 | −533.3 | −498.9 | ||
| C-index | 0.775 [95% CI, 0.742-0.808] | 0.719 [95% CI, 0.678-0.760] | 0.659 [95% CI, 0.610-0.708] | ||
| Model predictive accuracy — 3D-GLS model vs LV ejection fraction model | 0.116 | P < 0.001 |
Adverse outcomes · median follow-up of 17.6 months
- Patients experienced adverse outcomes
- 150
Adverse outcomes, independent predictors
- 2D-GLS hazard ratio
- 1.323 [95% CI, 1.225-1.429]; P <0.001
- 3D-GLS hazard ratio
- 1.412 [95% CI, 1.316-1.515]; P <0.001
- After adjustment for confounders
Addition of 2D-GLS and 3D-GLS to the base model
- Integrated discrimination improvement (2D-GLS and 3D-GLS)
- 0.225 and 0.280
- Net reclassification improvement (2D-GLS and 3D-GLS)
- 0.612 and 0.734
- P <0.001 for all
Original publication
Prognostic Value of LV Global Longitudinal Strain by 2D and 3D Speckle-Tracking Echocardiography in Patients With HFpEF. Circ Cardiovasc Imaging. Published 13 January 2025. doi:10.
Summarised from the published abstract; every number is checked against it