Author + information
- Luigi Adamo,
- Andrew Perry,
- Eric Novak,
- Majesh Makan,
- Brian Lindman,
- Douglas Mann and
- Cardiovascular Division
Background: Recovered LVEF often returns sub-normal during follow up but there are no tools to stratify the risk of this event. We sought to characterize Global Longitudinal Strain (GLS) in patients with recovered LVEF and to test the hypothesis that GLS at the time of recovery might be able to risk stratify patients in terms of their likelihood of sustaining a recovered LVEF during post-recovery follow-up.
Methods: We retrospectively identified 96 patients who had a reduced LVEF (<50%) that recovered to >50%. We analyzed global longitudinal strain (GLS) at the time of EF recovery and assessed its correlation with LVEF at follow-up.
Results: Average LVEF at the time of screening was 36.5%. Average follow up time between the initial echocardiogram and the time of recovery was 408 ± 223 days. About one-third of patients with recovered LVEF had normal GLS (absolute GLS >16%) at recovery. GLS at the time of recovery correlated with LVEF at follow-up (r=0.33, p<0.001). The likelihood of having an LVEF >50% during follow-up increased by 24% per each point increase in absolute GLS at the time of recovery (OR 1.24, p=0.001), independent of time of follow up. A sub-normal GLS at the time of recovery predicted a drop in LVEF of >5% during follow-up with a sensitivity of 87.5% while a normal GLS at the time of recovery predicted no changes in LVEF during follow-up with a specificity of 82.7%. Stratification of patients as a function of both LVEF at recovery (50-55% or >55%) and GLS at recovery (≤16% or >16%) identified patients with LVEF >55% and aGLS >16% (n=20) as a group of very low risk for recurrent LVEF <50%.
Conclusions: In patients with recovered LVEF, global longitudinal strain at the time of recovery predicts the likelihood of large negative changes in LVEF during follow up and the likelihood of sustained recovery. The simple combination of LVEF >55% and absolute GLS >16% at recovery identifies patients at very low risk of redeveloping a depressed LVEF during follow-up.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-271
- 2017 American College of Cardiology Foundation