title: Left Ventricular global longitudinal strain predicts heart failure readmission in acute decompensated heart failure.
abstract: BACKGROUND
  The goal of this study was to determine if left ventricular (LV) global longitudinal strain (GLS) predicts heart failure (HF) readmission in patients with acute decompensated heart failure.
  
  
  RESULTS
  Two hundred ninety one patients were enrolled at the time of admission for acute decompensated heart failure between January 2011 and September 2013. Left ventricle global longitudinal strain (LV GLS) by velocity vector imaging averaged from 2, 3 and 4-chamber views could be assessed in 204 out of 291 (70%) patients. Mean age was 63.8 ± 15.2 years, 42% of the patients were males and 78% were African American or Hispanic. Patients were followed until the first HF hospital readmission up to 44 months. Patients were grouped into quartiles on the basis of LV GLS. Kaplan-Meier curves showed significantly higher readmission rates in patients with worse LV GLS (log-rank p < 0.001). After adjusting for age, sex, history of ischemic heart disease, dementia, New York Heart Association class, LV ejection fraction, use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers, systolic and diastolic blood pressure on admission and sodium level on admission, worse LV GLS was the strongest predictor of recurrent HF readmission (p < 0.001). The ejection fraction was predictive of readmission in univariate, but not in multivariate analysis.
  
  
  CONCLUSIONS
  LV GLS is an independent predictor of HF readmission after acute decompensated heart failure with a higher risk of readmission in case of progressive worsening of LV GLS, independent of the ejection fraction.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.|Department of Medicine, University of Verona, Ospedale policlinico Borgo Roma, Piazzale scuro 10, 37134, Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Romano
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Ibrahim N
authors.initials: IN
authors.lastname: Mansour
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Mayank
authors.initials: M
authors.lastname: Kansal
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Hana
authors.initials: H
authors.lastname: Gheith
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Dowdy
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Dickens
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Buto-Colletti
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: June M
authors.initials: JM
authors.lastname: Chae
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA.
authors.forename: Hussam H
authors.initials: HH
authors.lastname: Saleh
authors.affiliation: Division of Cardiology, Department of Medicine, University of Illinois at Chicago, 840 S. Wood Street, M/C 715, Chicago, IL, 60612, USA. tstamos@uic.edu.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Stamos
mesh_terms: D000208:Acute Disease; D000368:Aged; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Echocardiography; Heart failure; Strain analysis