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Post-systolic shortening is superior to global longitudinal strain in predicting adverse events in patients with stable coronary artery disease and preserved systolic function

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单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Med Ultrasound, 1095 Jiefang Rd, Wuhan 430030, Peoples R China
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关键词: Stable coronary artery disease Speckle tracking echocardiography Automated functional imaging Post-systolic shortening Global longitudinal strain

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Background Post-systolic shortening (PSS) is an important indicator for early identifying myocardial dysfunction. We aimed to investigate the predictive value of PSS assessed with speckle tracking automated functional imaging (AFI) on adverse events in patients with stable coronary artery disease (CAD) and preserved systolic function. Methods A total of 204 consecutive patients clinically diagnosed with stable CAD and left ventricular ejection fraction (LVEF) > 50% were included. Multiple parameters were analyzed with AFI technique. The composite endpoint included all-cause mortality, heart failure, myocardial infarction and stroke. Results During a median follow-up of 24 months (IQR 19-28 months), 30 patients (14.7%) reached the endpoint. Patients experiencing the endpoint had a lower absolute global longitudinal strain (GLS), a higher post-systolic index (PSI), and more left ventricle walls displaying PSS than patients without events. PSI (hazard ratio, 1.15; 95% CI, 1.04-1.27; p = 0.005) and per 1 increase in the number of left ventricle walls with PSS (hazard ratio 1.52, 95% CI 1.21-1.91, p < 0.000) were independent predictors of the endpoint, whereas GLS was not significantly associated with the endpoint after adjustment models. For patients with absolute value of GLS > 15.4%, a significant prognostic superiority was found in PSI compared with GLS (AUC = 0.73 [PSI] vs. 0.58 [GLS], p = 0.024). Conclusions PSS is an independent predictor for adverse events in stable CAD patients with preserved systolic function, and the prognostic value may be superior to GLS in patients with normal or mildly reduced GLS.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 核医学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 核医学
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出版当年[2020]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Med Ultrasound, 1095 Jiefang Rd, Wuhan 430030, Peoples R China
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