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Prediction of prognosis in patients with systolic heart failure (HF) is of clinical importance.
To test the hypothesis that global circumferential strain (GCS) as a new measure of left ventricular (LV) function may predict prognosis using novel cardiac magnetic resonance (CMR) Feature Tracking analysis or echocardiographic speckle tracking.
We studied 120 consecutive HF patients, aged 59±16 yrs, referred for CMR with ejection fraction ≤35%; 90 also had echocardigraphy. GCS was determined from mid-LV short axis images using Feature Tracking software (TomTec Corp.) applied to routine DICOM CMR images and speckle tracking applied to echo images. Long-term outcome events were predefined as death, transplant or LV assist device (LVAD) over 1.5 years.
Group mean GCS was 8±4% by CMR feature tracking and was similar by echo speckle tracking 11±7%. There were 25 unfavorable events: 17 deaths, 2 transplants, and 4 LVADs. Using receiver operater characteristic curve analysis for event-free survival a GCS cut-off of 6.5% was determined. GCS < 6.5% was highly significantly associated with poor clinical outcomes: CMR hazard ratio (HR) of 3.06 with a 95% CI of 1.35–6.94, p=0.0076, and echo HR of 5.07 with a 95% CI of 1.79–14.37, p=0.0023.
GCS is a novel non-invasive imaging approach that may be successfully applied to routine clinical CMR and echo images that predicts survival in patients with systolic HF, and has promise for clinical utility.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: New Diagnostic and Imaging Strategies in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1136-300
- 2013 American College of Cardiology Foundation