Left Ventricular 3-Dimensional Global Longitudinal Strain Predicts All-Cause Mortality in Patients With Heart Transplant.

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  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Wiley-Blackwell
    • Subject Terms:
      Heart Transplantation*/mortality ; Echocardiography, Three-Dimensional* ; Ventricular Function, Left*/physiology; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Predictive Value of Tests ; Adult ; Cause of Death ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Risk Assessment/methods ; Prognosis ; Aged ; Risk Factors ; ROC Curve ; Global Longitudinal Strain
    • Abstract:
      Background: The prognostic value of 3-dimensional (3D)-left ventricular global longitudinal strain (LVGLS) in recipients of heart transplant (HT) reremains unknown. This study aimed to determine whether 3D-LVGLS was the more powerful predictor of poor outcomes in recipients of HT compared with 2-dimensional (2D)-LVGLS.
      Methods and Results: All consecutive adult patients who received HT and underwent at least 1 comprehensive 2D and 3D transthoracic echocardiographic examination for clinical surveillance were retrospectively enrolled. The end point was all-cause mortality. Prognostic model performance was assessed according to the C-statistic. The 3D-LVGLS measurements were feasible in 294 of 342 patients with HT (86%). The median follow-up time was 53 months, and 44 HT redied. Receiver operating characteristic curves revealed that the area under the curve for predicting all-cause mortality was greater for 3D-LVGLS than 2D-LVGLS (0.77 versus 0.67, P =0.012). When HT stratified patients with HT into tertiles according to 3D-LVGLS values, patients with lower 3D-LVGLS had worse outcome ( P <0.001). The multivariable Cox analysis showed that the model with 3D-LVGLS (hazard ratio [HR],1.44 [95% CI,1.24-1.68]; P <0.001; C-statistic=0.814) was better in predicting death than the model with 2D-LVGLS (HR, 1.19 [95% CI, 1.06-1.32]; P =0.002; C-statistic=0.772). The best cutoff value of 3D-LVGLS for detecting all-cause mortality was -16.1%, with a sensitivity of 63.6% and a specificity of 84.0%.
      Conclusions: The 3D-LVGLS was a powerful predictor of all-cause mortality in patients receiving HT and provided greater prognostic value than 2D-LVGLS. Our study highlighted the potential of evaluating 3D-LVGLS for risk stratification in recipients of HT.
    • Contributed Indexing:
      Keywords: all‐cause mortality; heart transplant; left ventricular global longitudinal strain; speckle tracking echocardiography
    • Publication Date:
      Date Created: 20241127 Date Completed: 20241203 Latest Revision: 20241203
    • Publication Date:
      20241204
    • Accession Number:
      10.1161/JAHA.124.036596
    • Accession Number:
      39604024