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Global longitudinal strain corrected by RR interval is a superior predictor of all-cause mortality in patients with systolic heart failure and atrial fibrillation.
- Source :
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ESC heart failure [ESC Heart Fail] 2018 Apr; Vol. 5 (2), pp. 311-318. Date of Electronic Publication: 2017 Oct 11. - Publication Year :
- 2018
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Abstract
- Aims: Quantification of systolic function in patients with atrial fibrillation (AF) is challenging. A novel approach, based on RR interval correction, to counteract the varying heart cycle lengths in AF has recently been proposed. Whether this method is superior in patients with systolic heart failure (HFrEF) with AF remains unknown. This study investigates the prognostic value of RR interval-corrected peak global longitudinal strain {GLSc = GLS/[RR^(1/2)]} in relation to all-cause mortality in HFrEF patients displaying AF during echocardiographic examination.<br />Methods and Results: Echocardiograms from 151 patients with HFrEF and AF during examination were analysed offline. Peak global longitudinal strain (GLS) was averaged from 18 myocardial segments obtained from three apical views. GLS was indexed with the square root of the RR interval {GLSc = GLS/[RR^(1/2)]}. Endpoint was all-cause mortality. During a median follow-up of 2.7 years, 40 patients (26.5%) died. Neither uncorrected GLS (P = 0.056) nor left ventricular ejection fraction (P = 0.053) was significantly associated with all-cause mortality. After RR^(1/2) indexation, GLSc became a significant predictor of all-cause mortality (hazard ratio 1.16, 95% confidence interval 1.02-1.22, P = 0.014, per %/s^(1/2) decrease). GLSc remained an independent predictor of mortality after multivariable adjustment (age, sex, mean heart rate, mean arterial blood pressure, left atrial volume index, and E/e') (hazard ratio 1.17, 95% confidence interval 1.05-1.31, P = 0.005 per %/s^(1/2) decrease).<br />Conclusions: Decreasing {GLSc = GLS/[RR^(1/2)]}, but not uncorrected GLS nor left ventricular ejection fraction, was significantly associated with increased risk of all-cause mortality in HFrEF patients with AF and remained an independent predictor after multivariable adjustment.<br /> (© 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)
- Subjects :
- Aged
Atrial Fibrillation complications
Atrial Fibrillation mortality
Cause of Death trends
Denmark epidemiology
Echocardiography
Female
Follow-Up Studies
Heart Failure, Systolic complications
Heart Failure, Systolic mortality
Heart Ventricles diagnostic imaging
Humans
Male
Prognosis
Retrospective Studies
Survival Rate trends
Ventricular Function, Left
Atrial Fibrillation physiopathology
Electrocardiography
Heart Failure, Systolic physiopathology
Heart Ventricles physiopathology
Myocardial Contraction physiology
Risk Assessment
Stroke Volume physiology
Subjects
Details
- Language :
- English
- ISSN :
- 2055-5822
- Volume :
- 5
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- ESC heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 29024533
- Full Text :
- https://doi.org/10.1002/ehf2.12220