Page 118 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou

Chapter six. Layer-specific LV GLS and prognosis
190 mg/dl or previous pharmacological treatment. Diabetes mellitus was defined as fasting blood glucose ≥7.0 mmol/L, 2-h oral glucose tolerance test glucose ≥11.1 mmol/L or previous pharmacological treatment. p-values are presented for the comparisons between different groups.
Table 2. Baseline echocardiographic findings for study population.
Survivor
Variable
Total population (n=569)
Yes (n=474)
No (n=95)
p-value
BSA, m2
LV mass, indexed (g/m2)
LV end-diastolic volume (ml)
LV end-systolic volume (ml)
LV ejection fraction (%)
LV end-diastolic diameter (mm) LV end-systolic diameter (mm) Wall motion score index
Mitral regurgitation ≥2, n (%) E-prime (cm/s)
E/e’ ratio
E/A ratio
Deceleration time (ms)
LV Global longitudinal strain (%) LV GLS at endocardium (%)
LV GLS at mid-myocardium (%) LV GLS at epicardium (%)
2.0 ± 0.2
107 ± 28 98 (77-121) 47 (37-57) 52 (47-57) 47 ± 6
31 ± 6 1.4 ± 0.3 31 (6)
5.8 (4.7-6.9) 12 (9-14) 0.9 (0.8-1.1) 218 (171-271) -15.1 ± 3.2 -17.5 ± 3.6 -15.3 ± 3.2 -13.2 ± 2.9
2.0 ± 0.2
107 ± 28 100 (79-121) 48 (37-57) 52 (48-57) 47 ± 5
31 ± 6
1.4 ± 0.3 22 (5)
5.9 (4.7-7.1) 12 (9-14) 0.9 (0.8-1.1) 208 (170-271) -15.3 ± 3.2 -17.7 ± 3.6 -15.6 ± 3.2 -13.4 ± 2.8
1.9 ± 0.2
109 ± 28 89 (69-112) 42 (33-54) 51 (47-56) 46 ± 6
30 ± 7
1.6 ± 0.3
9 (10)
5.2 (4.3-6.4) 13 (10-17) 0.9 (0.7-1.0) 211 (179-264) -13.9 ± 3.2 -16.5 ± 3.7 -14.2 ± 3.2 -11.9 ± 2.8
<0.001 0.534 0.002 0.033 0.257 0.120 0.458 0.697 0.077 0.002 0.012 0.002 0.165 <0.001 0.005 <0.001 <0.001
Data are presented as mean ± standard deviation, number (percentage) or as median (25th- 75th percentile). BSA = body surface area; LV = left ventricular. p-values are presented for the comparisons between different groups.
Survival analysis
A total of 95 patients (17%) died during a median follow-up of 117 (IQR 106-132) months. The Kaplan-Meier curves for all-cause mortality according to each layer-specific LV GLS are shown in Figure 2. The population was divided into two groups according the median LV GLS of each individual layer. The cumulative survival rates were significantly higher for patients with preserved LV GLS (more negative) at the mid-myocardium (≤-15.3%; χ2= 4.2, log-rank p=0.041) and the epicardium (≤-13.0%; χ2= 8.8, log-rank p=0.003). On univariable Cox regression analysis, associates of all-cause mortality were age, male, gender, body mass index, heart rate at discharge, eGFR, Killip class ≥2, multi-vessel disease, end-diastolic volume and end-systolic volume.
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