Kristoffer Grundtvig Skaarup1, Allan Iversen1, Peter Godsk Jørgensen1, Flemming Javier Olsen1, Gabriela Llado Grove1,2, Jan Skov Jensen1,3, Tor Biering-Sørensen1,2. 1. Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, Copenhage Denmark. 2. Cardiovascular Medicine Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA. 3. Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N., Denmark.
Abstract
Aims: To investigate the prognostic value of layer-specific global longitudinal strain (GLS) in predicting heart failure (HF) and cardiovascular death (CD) following acute coronary syndrome (ACS). Methods and results: In this retrospective study, 465 ACS patients underwent transthoracic echocardiography following percutaneous coronary intervention (PCI). The primary endpoint was the composite of HF and/or CD with a median follow-up time of 4.6 (0.2-6.3) years. During follow-up 199 patients (42.7%) suffered HF and/or CD (176 developed HF and 38 suffered CD). Absolute endomyocardial global longitudinal strain (GLSendo) (12% vs. 17%, P < 0.001), GLS (11% vs. 14%, P < 0.001), and epimyocardial global longitudinal strain (GLSepi) (9% vs. 13%, P < 0.001) were all reduced in patients with an adverse outcome. In multivariable Cox regressions, which included clinical baseline characteristics and conventional echocardiographic measurements, GLS obtained from all layers remained independently associated with the composite outcome; GLSendo [hazard ratio: 1.19 (1.10-1.28), P < 0.001, per 1% decrease], GLS [hazard ratio 1.24 (1.14-1.35), P < 0.001, per 1% decrease], and GLSepi [hazard ratio 1.26 (1.15-1.39), P < 0.001, per 1% decrease]. No other echocardiographic measures remained independently associated with the composite outcome in these models. Finally, GLS and GLSepi provided incremental prognostic information on the risk of developing the composite endpoint, when added to all other clinical and echocardiographic measures [adding GLS (c-statistics: 0.76 vs. 0.74, P = 0.048) or adding GLSepi (c-statistics: 0.76 vs. 0.74, P = 0.039)]. Conclusion: In ACS patients, layer-specific strain provides independent prognostic information regarding risk of developing HF and/or CD. Furthermore, only GLS and GLSepi provided incremental prognostic information when added to all other significant predictors.
Aims: To investigate the prognostic value of layer-specific global longitudinal strain (GLS) in predicting heart failure (HF) and cardiovascular death (CD) following acute coronary syndrome (ACS). Methods and results: In this retrospective study, 465 ACS patients underwent transthoracic echocardiography following percutaneous coronary intervention (PCI). The primary endpoint was the composite of HF and/or CD with a median follow-up time of 4.6 (0.2-6.3) years. During follow-up 199 patients (42.7%) suffered HF and/or CD (176 developed HF and 38 suffered CD). Absolute endomyocardial global longitudinal strain (GLSendo) (12% vs. 17%, P < 0.001), GLS (11% vs. 14%, P < 0.001), and epimyocardial global longitudinal strain (GLSepi) (9% vs. 13%, P < 0.001) were all reduced in patients with an adverse outcome. In multivariable Cox regressions, which included clinical baseline characteristics and conventional echocardiographic measurements, GLS obtained from all layers remained independently associated with the composite outcome; GLSendo [hazard ratio: 1.19 (1.10-1.28), P < 0.001, per 1% decrease], GLS [hazard ratio 1.24 (1.14-1.35), P < 0.001, per 1% decrease], and GLSepi [hazard ratio 1.26 (1.15-1.39), P < 0.001, per 1% decrease]. No other echocardiographic measures remained independently associated with the composite outcome in these models. Finally, GLS and GLSepi provided incremental prognostic information on the risk of developing the composite endpoint, when added to all other clinical and echocardiographic measures [adding GLS (c-statistics: 0.76 vs. 0.74, P = 0.048) or adding GLSepi (c-statistics: 0.76 vs. 0.74, P = 0.039)]. Conclusion: In ACS patients, layer-specific strain provides independent prognostic information regarding risk of developing HF and/or CD. Furthermore, only GLS and GLSepi provided incremental prognostic information when added to all other significant predictors.
Authors: Christoffer A Hagemann; Søren Hoffmann; Rikke A Hagemann; Thomas Fritz-Hansen; Flemming J Olsen; Peter G Jørgensen; Tor Biering-Sørensen Journal: Int J Cardiovasc Imaging Date: 2019-06-21 Impact factor: 2.357
Authors: Philip Brainin; Kristoffer Grundtvig Skaarup; Allan Zeeberg Iversen; Peter Godsk Jørgensen; Elke Platz; Jan Skov Jensen; Tor Biering-Sørensen Journal: Int J Cardiol Date: 2018-11-22 Impact factor: 4.164
Authors: Alexander Isaak; Dmitrij Kravchenko; Narine Mesropyan; Christoph Endler; Leon M Bischoff; Thomas Vollbrecht; Daniel Thomas; Darius Dabir; Sebastian Zimmer; Ulrike Attenberger; Daniel Kuetting; Julian A Luetkens Journal: Radiol Cardiothorac Imaging Date: 2022-06-09
Authors: Kristoffer Grundtvig Skaarup; Mats Christian Højbjerg Lassen; Jacob Louis Marott; Sofie R Biering-Sørensen; Peter Godsk Jørgensen; Merete Appleyard; Jens Berning; Nis Høst; Gorm Jensen; Peter Schnohr; Peter Søgaard; Gunnar Gislason; Rasmus Møgelvang; Tor Biering-Sørensen Journal: Int J Cardiovasc Imaging Date: 2020-06-07 Impact factor: 2.357
Authors: Lingyu Xu; Joseph J Pagano; Mark J Haykowksy; Justin A Ezekowitz; Gavin Y Oudit; Yoko Mikami; Andrew Howarth; James A White; Jason R B Dyck; Todd Anderson; D Ian Paterson; Richard B Thompson Journal: J Cardiovasc Magn Reson Date: 2020-12-03 Impact factor: 5.364