Cardiac-Magnetic Resonance (CMR) feature-tracking derived global longitudinal strain (GLS) "is a powerful independent predictor of mortality in patients with preserved ejection fraction, incremental to common clinical and imaging risk factors," according to research being presented at AHA 2019 in Philadelphia, PA.

The retrospective study, which was also published Nov. 11 in JACC: Cardiovascular Imaging, was based on 1,274 patients at four U.S. medical centers presenting with preserved ejection fraction (EF ≥50 percent) and a clinical indication for CMR. The primary endpoint was all-cause death. During the median follow-up period of 6.2 years, 115 patients died.

Results found that patients with GLS ≥median (-20 percent) had significantly reduced event-free survival compared to those with GLS <median (log-rank p<0.001) based on Kaplan-Meier-analysis. Using Cox multivariable regression modeling, researchers noted that each 1 percent worsening in GLS was associated with a 22.8 percent increase in risk-of-death after adjustment for clinical and imaging risk factors.

The findings demonstrate "that GLS provides prognostic information incremental to common clinical and CMR risk factors - including late gadolinium enhancement," said Simone Romano, MD, and colleagues. "These findings highlight the importance of long-axis function and suggest a role for feature tracking GLS in identifying patients at highest risk of death, despite a preserved ejection fraction."

Keywords: Kaplan-Meier Estimate, Risk Factors, Disease-Free Survival, Gadolinium, Stroke Volume, Proportional Hazards Models, Magnetic Resonance Spectroscopy, AHA19, AHA Annual Scientific Sessions

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