Rodrigue Garcia1, Michaela Rehman2, Cyril Goujeau2, Bruno Degand2, François Le Gal2, Benjamin Stordeur2, Quentin Labarre2, Luc Christiaens3, Claire Bouleti4. 1. CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France. Electronic address: rodrigue.garcia@chu-poitiers.fr. 2. CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France. 3. CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France; Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France. 4. Assistance Publique-Hôpitaux de Paris, Hopital Bichat, Service de Cardiologie, F-75018 Paris, France.
Abstract
BACKGROUND: Type 1 myotonic dystrophy (DM1) patients' prognosis is very poor. Up until now, only a few prognostic factors for cardiovascular events have been identified, and they are predictive of end-stage disease. The aim was to assess the prognostic value of global longitudinal strain (GLS) for cardiovascular events in asymptomatic DM1 patients. METHODS: DM1 patients were included between 2011 and 2015 and followed up until January 2016. Patients underwent a transthoracic echocardiography at inclusion. The primary endpoint was a composite of all-cause mortality, type 2 Mobitz 2 and type 3 atrioventricular block, symptomatic sino-atrial block, HV interval≥70ms at invasive electrophysiology exploration, left ventricular ejection fraction (LVEF) ≤45% and newly developed atrial fibrillation. RESULTS: Forty-six patients (25 males, mean age 40years old) were included. The primary outcome was reached in 14 patients with a mean follow-up of 38months. GLS of patients who reached the primary endpoint was significantly impaired as compared to those who did not (-15.1 [-16.7; -12.7] vs. -18.2 [-19.2; -16.7] respectively; P=0.001). According to ROC curve analysis, probability of primary outcome occurrence was significantly greater in patients with GLS values≥-17.2% (P=0.001). On multivariate analysis, PR electrocardiogram interval and GLS remained significantly and independently associated with the primary endpoint [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.01-1.04, P=0.006 for PR interval; HR 1.4, 95% CI 1.1-1.7, P=0.002 for GLS] while LVEF alone was not. CONCLUSION: Left ventricular GLS is a powerful marker to predict cardiovascular events in asymptomatic DM1 patients, independently of LVEF.
BACKGROUND: Type 1 myotonic dystrophy (DM1) patients' prognosis is very poor. Up until now, only a few prognostic factors for cardiovascular events have been identified, and they are predictive of end-stage disease. The aim was to assess the prognostic value of global longitudinal strain (GLS) for cardiovascular events in asymptomatic DM1 patients. METHODS: DM1 patients were included between 2011 and 2015 and followed up until January 2016. Patients underwent a transthoracic echocardiography at inclusion. The primary endpoint was a composite of all-cause mortality, type 2 Mobitz 2 and type 3 atrioventricular block, symptomatic sino-atrial block, HV interval≥70ms at invasive electrophysiology exploration, left ventricular ejection fraction (LVEF) ≤45% and newly developed atrial fibrillation. RESULTS: Forty-six patients (25 males, mean age 40years old) were included. The primary outcome was reached in 14 patients with a mean follow-up of 38months. GLS of patients who reached the primary endpoint was significantly impaired as compared to those who did not (-15.1 [-16.7; -12.7] vs. -18.2 [-19.2; -16.7] respectively; P=0.001). According to ROC curve analysis, probability of primary outcome occurrence was significantly greater in patients with GLS values≥-17.2% (P=0.001). On multivariate analysis, PR electrocardiogram interval and GLS remained significantly and independently associated with the primary endpoint [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.01-1.04, P=0.006 for PR interval; HR 1.4, 95% CI 1.1-1.7, P=0.002 for GLS] while LVEF alone was not. CONCLUSION:Left ventricular GLS is a powerful marker to predict cardiovascular events in asymptomatic DM1 patients, independently of LVEF.
Authors: Alexandre Gamet; Bruno Degand; François Le Gal; Nicolas Bidegain; Anne Delaubier; Brigitte Gilbert-Dussardier; Luc Christiaens; Rodrigue Garcia Journal: Ann Noninvasive Electrocardiol Date: 2018-08-12 Impact factor: 1.468
Authors: Johannes Schmid; Meinrad Beer; Andrea Berghold; Tatjana Stojakovic; Hubert Scharnagl; Benjamin Dieplinger; Stefan Quasthoff; Josepha S Binder; Peter P Rainer Journal: ESC Heart Fail Date: 2020-05-31
Authors: Marco Alì; Caterina Beatrice Monti; Luca Melazzini; Rosanna Cardani; Barbara Fossati; Michele Cavalli; Kelvin Chow; Francesco Secchi; Giovanni Meola; Francesco Sardanelli Journal: Front Neurol Date: 2020-03-19 Impact factor: 4.003