Prognostic utility of blood pressure-adjusted global and basal systolic longitudinal strain

Isaac B. Rhea, Shuja Rehman, Upasana Jarori, Muhammad W. Choudhry, Harvey Feigenbaum, Stephen Sawada

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Assessment of global longitudinal systolic strain (GLS) and longitudinal systolic strain of the basal segments (BLS) has shown prognostic value in cardiac disorders. However, strain is reduced with increased afterload. We assessed the prognostic value of GLS and BLS adjusted for afterload. GLS and BLS were determined in 272 subjects with normal ejection fraction and no known coronary disease, or significant valve disease. Systolic blood pressure (SP) and diastolic blood pressure (DP) obtained at the time of echocardiography were used to adjust GLS and BLS as follows: strain ? SP (mmHg)/120 mmHg and strain ? DP (mmHg)/80 mmHg. Patients were followed for cardiac events and mortality. The mean age was 53 ± 15 years and 53% had hypertension. There were 19 cardiac events and 70 deaths over a mean follow-up of 26 ± 14 months. Cox analysis showed that left ventricular mass index (P = 0.001), BLS (P < 0.001), and DP-adjusted BLS (P < 0.001) were independent predictors of cardiac events. DP-adjusted BLS added incremental value (P < 0.001) to the other two predictors and had an area under the curve of 0.838 for events. DP (P = 0.001), age (P = 0.001), ACE inhibitor use (P = 0.017), and SP-adjusted BLS (P = 0.012) were independent predictors of mortality. SP-adjusted BLS added incremental value (P = 0.014) to the other independent predictors. In conclusion, DP-adjusted BLS and SP-adjusted BLS were independent predictors of cardiac events and mortality, respectively. Blood pressureadjusted strain added incremental prognostic value to other predictors of outcome.

Original languageEnglish (US)
Pages (from-to)17-24
Number of pages8
JournalEcho Research and Practice
Volume3
Issue number1
DOIs
StatePublished - Mar 1 2016

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Blood Pressure
Mortality
Angiotensin-Converting Enzyme Inhibitors
Area Under Curve
Coronary Disease
Echocardiography

Keywords

  • 2d speckle-tracking echocardiography
  • Afterload
  • Basal systolic
  • Blood pressure
  • Global systolic
  • Longitudinal strain
  • Longitudinal strain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Advanced and Specialized Nursing

Cite this

Prognostic utility of blood pressure-adjusted global and basal systolic longitudinal strain. / Rhea, Isaac B.; Rehman, Shuja; Jarori, Upasana; Choudhry, Muhammad W.; Feigenbaum, Harvey; Sawada, Stephen.

In: Echo Research and Practice, Vol. 3, No. 1, 01.03.2016, p. 17-24.

Research output: Contribution to journalArticle

Rhea, Isaac B. ; Rehman, Shuja ; Jarori, Upasana ; Choudhry, Muhammad W. ; Feigenbaum, Harvey ; Sawada, Stephen. / Prognostic utility of blood pressure-adjusted global and basal systolic longitudinal strain. In: Echo Research and Practice. 2016 ; Vol. 3, No. 1. pp. 17-24.
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AU - Sawada, Stephen

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N2 - Assessment of global longitudinal systolic strain (GLS) and longitudinal systolic strain of the basal segments (BLS) has shown prognostic value in cardiac disorders. However, strain is reduced with increased afterload. We assessed the prognostic value of GLS and BLS adjusted for afterload. GLS and BLS were determined in 272 subjects with normal ejection fraction and no known coronary disease, or significant valve disease. Systolic blood pressure (SP) and diastolic blood pressure (DP) obtained at the time of echocardiography were used to adjust GLS and BLS as follows: strain ? SP (mmHg)/120 mmHg and strain ? DP (mmHg)/80 mmHg. Patients were followed for cardiac events and mortality. The mean age was 53 ± 15 years and 53% had hypertension. There were 19 cardiac events and 70 deaths over a mean follow-up of 26 ± 14 months. Cox analysis showed that left ventricular mass index (P = 0.001), BLS (P < 0.001), and DP-adjusted BLS (P < 0.001) were independent predictors of cardiac events. DP-adjusted BLS added incremental value (P < 0.001) to the other two predictors and had an area under the curve of 0.838 for events. DP (P = 0.001), age (P = 0.001), ACE inhibitor use (P = 0.017), and SP-adjusted BLS (P = 0.012) were independent predictors of mortality. SP-adjusted BLS added incremental value (P = 0.014) to the other independent predictors. In conclusion, DP-adjusted BLS and SP-adjusted BLS were independent predictors of cardiac events and mortality, respectively. Blood pressureadjusted strain added incremental prognostic value to other predictors of outcome.

AB - Assessment of global longitudinal systolic strain (GLS) and longitudinal systolic strain of the basal segments (BLS) has shown prognostic value in cardiac disorders. However, strain is reduced with increased afterload. We assessed the prognostic value of GLS and BLS adjusted for afterload. GLS and BLS were determined in 272 subjects with normal ejection fraction and no known coronary disease, or significant valve disease. Systolic blood pressure (SP) and diastolic blood pressure (DP) obtained at the time of echocardiography were used to adjust GLS and BLS as follows: strain ? SP (mmHg)/120 mmHg and strain ? DP (mmHg)/80 mmHg. Patients were followed for cardiac events and mortality. The mean age was 53 ± 15 years and 53% had hypertension. There were 19 cardiac events and 70 deaths over a mean follow-up of 26 ± 14 months. Cox analysis showed that left ventricular mass index (P = 0.001), BLS (P < 0.001), and DP-adjusted BLS (P < 0.001) were independent predictors of cardiac events. DP-adjusted BLS added incremental value (P < 0.001) to the other two predictors and had an area under the curve of 0.838 for events. DP (P = 0.001), age (P = 0.001), ACE inhibitor use (P = 0.017), and SP-adjusted BLS (P = 0.012) were independent predictors of mortality. SP-adjusted BLS added incremental value (P = 0.014) to the other independent predictors. In conclusion, DP-adjusted BLS and SP-adjusted BLS were independent predictors of cardiac events and mortality, respectively. Blood pressureadjusted strain added incremental prognostic value to other predictors of outcome.

KW - 2d speckle-tracking echocardiography

KW - Afterload

KW - Basal systolic

KW - Blood pressure

KW - Global systolic

KW - Longitudinal strain

KW - Longitudinal strain

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