PMID- 26857213 OWN - NLM STAT- MEDLINE DCOM- 20170703 LR - 20220129 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) VI - 102 IP - 10 DP - 2016 May 15 TI - Global longitudinal strain is associated with heart failure outcomes in hypertrophic cardiomyopathy. PG - 741-7 LID - 10.1136/heartjnl-2015-308576 [doi] AB - OBJECTIVE: We hypothesised that abnormal global longitudinal strain (GLS) would predict outcome in hypertrophic cardiomyopathy (HCM) better than current echocardiographic measures. METHODS: Retrospective analysis of risk markers in relation to outcomes in 472 patients with HCM at a single tertiary institution (2006-2012). Exclusion criteria were left ventricular (LV) hypertrophy of other origin, patients in atrial fibrillation, lost to follow-up and insufficient image quality to perform strain analysis. Standardised echocardiogram recordings were reviewed and standard variables and LV GLS were measured. The primary end-point included all cardiac deaths, appropriate defibrillator shocks and heart failure (HF) admissions. The secondary end-point was death by HF and admissions related to HF. RESULTS: Mean age was 50.0+/-15.0 years; 322 (68%) were men. At a median of 4.3 years (IQR 0.1-7.8) follow-up, 21 (4.4%) patients experienced cardiovascular death: 6 (1.3%) died from HF, 13 (2.7%) had sudden cardiac death and 2 (0.4%) died secondary to stroke. Four (0.8%) patients experienced appropriate defibrillator shock, and 13 (2.7%) were admitted for HF. On multivariate Fine-Gray proportional hazard analyses, GLS was significantly associated with the primary end-point (HR=0.90, 95% CI 0.83 to 0.98, p=0.018) independently of age, maximal provoked LV outflow-tract gradient and LV end-systolic volume. Moreover, GLS was particularly associated with the secondary end-point (HR=0.82, 95% CI 0.75 to 0.90, p<0.0001) independently of age, previous atrial fibrillation, New York Heart Association (NYHA) class III-IV, LV end-systolic volume, E/E', and outflow-tract gradient. Survival curves confirmed that GLS was associated with HF events (GLS <15.6%, p=0.0035). CONCLUSIONS: In patients with HCM, reduced GLS is an independent factor associated with poor cardiac outcomes, and particularly HF outcomes. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ FAU - Reant, Patricia AU - Reant P AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK University of Bordeaux, CHU de Bordeaux, Bordeaux, France. FAU - Mirabel, Mariana AU - Mirabel M AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK Assistance Publique-Hopitaux de Paris, Hopital Europeen Georges Pompidou, Paris, France. FAU - Lloyd, Guy AU - Lloyd G AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Peyrou, Jerome AU - Peyrou J AD - University of Bordeaux, CHU de Bordeaux, Bordeaux, France. FAU - Lopez Ayala, Jose-Maria AU - Lopez Ayala JM AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Dickie, Shaughan AU - Dickie S AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Bulluck, Heeraj AU - Bulluck H AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Captur, Gabriella AU - Captur G AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Rosmini, Stefania AU - Rosmini S AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Guttmann, Oliver AU - Guttmann O AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Demetrescu, Camelia AU - Demetrescu C AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Pantazis, Antonis AU - Pantazis A AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Tome-Esteban, Maite AU - Tome-Esteban M AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Moon, James C AU - Moon JC AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. FAU - Lafitte, Stephane AU - Lafitte S AD - University of Bordeaux, CHU de Bordeaux, Bordeaux, France. FAU - McKenna, William J AU - McKenna WJ AD - Inherited Cardiac Disease Unit, The Heart Hospital; Institute of Cardiovascular Science, University College London, London, UK. LA - eng GR - FS/10/40/28260/BHF_/British Heart Foundation/United Kingdom GR - FS/12/56/29723/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20160208 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 SB - IM MH - Adult MH - Aged MH - Cardiomyopathy, Hypertrophic/diagnostic imaging/mortality/*physiopathology/therapy MH - Cause of Death MH - Echocardiography, Doppler, Color MH - Echocardiography, Doppler, Pulsed MH - Female MH - Heart Failure/diagnostic imaging/mortality/*physiopathology/therapy MH - Hospitalization MH - Humans MH - Kaplan-Meier Estimate MH - London MH - Male MH - Middle Aged MH - *Myocardial Contraction MH - Predictive Value of Tests MH - Prognosis MH - Retrospective Studies MH - Risk Factors MH - Stress, Mechanical MH - Time Factors MH - Ventricular Dysfunction, Left/diagnostic imaging/mortality/*physiopathology/therapy MH - *Ventricular Function, Left EDAT- 2016/02/10 06:00 MHDA- 2017/07/04 06:00 CRDT- 2016/02/10 06:00 PHST- 2015/08/20 00:00 [received] PHST- 2016/01/08 00:00 [accepted] PHST- 2016/02/10 06:00 [entrez] PHST- 2016/02/10 06:00 [pubmed] PHST- 2017/07/04 06:00 [medline] AID - heartjnl-2015-308576 [pii] AID - 10.1136/heartjnl-2015-308576 [doi] PST - ppublish SO - Heart. 2016 May 15;102(10):741-7. doi: 10.1136/heartjnl-2015-308576. Epub 2016 Feb 8.