title: Independent role of left ventricular global longitudinal strain in predicting prognosis of chronic heart failure patients.
abstract: OBJECTIVE
  To evaluate the independent prognostic role of two-dimensional (2D) strain measures reflecting global longitudinal left ventricular (LV) systolic function in outpatients affected by chronic heart failure (CHF).
  
  
  RESULTS
  Global longitudinal LV systolic strain (GLS) was assessed in 308 outpatients affected by CHF, by analyzing standard views with 2D speckle tracking technique. During a mean follow-up of 26 ± 13 months 37 patients died (29 due to cardiovascular causes), 10 patients underwent heart transplantation, and 75 patients experienced at least 1 episode of hospitalization due to acute decompensated heart failure (ADHF). Thirty-one patients without a history of major ventricular arrhythmic events experienced the occurrence of ventricular fibrillation and/or tachycardia or sudden death was observed. Multivariate Cox regression analysis showed that GLS was significantly associated with all-cause mortality (HR: 1.15; 95%CI: 1.02-1.30; P: 0.026), cardiovascular death (HR: 1.20; 95%CI: 1.04-1.39; P: 0.011), cardiovascular death or heart transplantation (HR: 1.24; 95%CI: 1.09-1.41; P: 0.001), ADHF-related hospitalizations (HR: 1.15; 95%CI: 1.05-1.25; P: 0.003), and arrhythmic events (HR: 1.17; 95%CI: 1.03-1.33; P: 0.018).
  
  
  CONCLUSIONS
  Quantifying LV longitudinal systolic function in CHF outpatients on the basis of 2D speckle tracking analysis provides a new parameter that independently predicts patient outcome, thus, strengthening its possible role in current clinical practice.
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. massimo.iacoviello@cardio.uniba.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Iacoviello
authors.forename: Agata
authors.initials: A
authors.lastname: Puzzovivo
authors.forename: Pietro
authors.initials: P
authors.lastname: Guida
authors.forename: Cinzia
authors.initials: C
authors.lastname: Forleo
authors.forename: Francesco
authors.initials: F
authors.lastname: Monitillo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Catanzaro
authors.forename: Maria Silvia
authors.initials: MS
authors.lastname: Lattarulo
authors.forename: Valeria
authors.initials: V
authors.lastname: Antoncecchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Favale
mesh_terms: D002908:Chronic Disease; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: heart failure; myocardial strain; prognosis; two-dimensional speckle tracking