Open AccessLeft ventricular global longitudinal strain predicts mortality and heart failure admissions in African American patients
Author(s) -
Kansal Mayank M.,
Mansour Ibrahim N.,
Ismail Sahar,
Bress Adam,
Wu Grace,
Mirza Omer,
Marpadga Rahul,
Gheith Hana,
Kim Yoonsang,
Li Yien,
Cavallari Larisa,
Stamos Thomas D.
Publication year - 2017
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22662
Subject(s) - medicine , hazard ratio , heart failure , cardiology , proportional hazards model , confidence interval , population , environmental health
Background Several studies have demonstrated the importance of left ventricular ( LV ) global longitudinal strain ( GLS ) as a reliable prognostic indicator in patients with heart failure ( HF ). These studies have included few African American ( AA ) patients, despite the growing prevalence and severity of HF in this patient population. Hypothesis LV GLS predicts long‐term HF admission and all‐cause mortality in AA patients with chronic HF on optimal guideline‐directed medical therapy ( GDMT ). Methods We enrolled 207 AA adults, age 56 ± 14.5 years, with New York Heart Association ( NYHA ) class I through III HF on optimal GDMT from the University of Illinois HF clinic between November 2001 and February 2014. LV GLS was assessed by velocity vector imaging using 2‐, 3‐, and 4‐chamber views. Patients were followed for HF admissions and death for 3 ± 3.0 years. LV GLS value of −7.95 was used as the optimal cutoff point that maximizes sensitivity and specificity Results LV GLS < −7.95% was significantly associated with higher all‐cause mortality and HF admissions in Kaplan‐Meier survival curves (log‐rank P < 0.001). After incorporation in multivariate Cox proportional hazard models, GLS < −7.95% was found to be an independent predictor of all‐cause mortality (hazard ratio [ HR ] = 4.04; 95% confidence interval [ CI ]: 1.07‐15.32; P = 0.04] and HF admissions ( HR = 3.86; 95% CI : 1.38‐10.77; P = 0.010). Conclusions In AA patients with chronic stable HF on GDMT , more impaired LV GLS (< −7.95%) is a strong and independent predictor of long‐term all‐cause mortality and HF admissions.