Hwang IC, et al. - An inquiry was set up with regard to the correlation between myocardial strain and twist and cardiovascular events in patients with left bundle branch block (LBBB), as revealed through the two-dimensional speckle-tracking echocardiography. The data depicted that global longitudinal strain (GLS) could provide a better risk stratification than left ventricular ejection fraction (LVEF) or other echocardiographic parameters, among the study cohort.

Methods

• The researchers enrolled 269 patients with LBBB (mean age, 69.5 ± 10.9 years; 46.8% men).
• Speckle-tracking estimated the LV global longitudinal strain (GLS), global circumferential strain, and twist.
• A comparison was performed of the link between LV global function and a composite of cardiovascular mortality and hospitalization for heart failure with clinical risk factors, LV ejection fraction (LVEF), and other echocardiographic parameters.

Results

• The composite end point occurred in 55 patients (20.4%), during a median of 27.5 months (interquartile range, 12.8-43.9 months).
• In univariate analyses, diabetes mellitus, chronic kidney disease, ischemic etiology of LBBB, dilated left atrium, reduced LVEF, dilated left ventricle, and impaired LV global strain (GLS > -12.2%, global circumferential strain > -11.8%, and twist < 6.5°) illustrated correlations with the composite end point.
• GLS appeared to be prominenty related to the composite end point (adjusted hazard ratio, 4.697; 95% CI, 1.344-16.413; P=.015), in multivariate analyses.
• ,On the other hand, this was not noted with the global circumferential strain, twist, and LVEF.
• GLS exhibited an additive connection with poor prognosis over clinical risk factors and other echocardiographic parameters, including LVEF.
• A larger number of clinical events occurred in patients with preserved LVEFs (≥40%) but impaired GLS (>-12.2%) than those with impaired LVEFs but preserved GLS.