Global 2-Dimensional Strain as a New Prognosticator in Patients With Heart Failure
Goo-Yeong Cho, MD, PhD*,*,
Thomas H. Marwick, MD, PhD ,
Hyun-Sook Kim, MD, PhD ,
Min-Kyu Kim, MD,
Kyung-Soon Hong, MD, PhD and
Dong-Jin Oh, MD, PhD
* Department of Medicine, Seoul National University, Seoul, South Korea
Department of Medicine, University of Queensland, Brisbane, Queensland, Australia
Department of Medicine, Hallym University Medical Center, Seoul, South Korea
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Figure 2 Incidence of Cardiac Events According to Etiology of Heart Failure
The cutoff values of global circumferential strain (GCS) and global longitudinal strain (GLS) were achieved by the highest sum of sensitivity and specificity using receiver-operating characteristic curve analysis.
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Figure 3 Prognostic Value of Echocardiographic Parameters
Incremental prognostic value of the risk factors (ratio of early transmitral flow to early diastolic annular velocity [E/e'], left ventricular ejection fraction, GLS, and GCS) by Cox proportional hazards model presented as a global chi-square value. The addition of GCS resulted in significant incremental improvement in the predictive value on the E/e', ejection fraction (EF), and GLS. Abbreviations as in Figure 1.
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Figure 4 Receiver-Operating Characteristic Curves to Predict Cardiac Events
Black line = GCS; green line = GLS; red line = left ventricular ejection fraction (LVEF). AUC = area under the receiver-operating characteristic curve; CI = confidence interval; other abbreviations as in Figure 1.
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Figure 5 Kaplan-Meier Analysis According to GCS
The cutoff value (–10.7%) was defined as the point with the highest sum of sensitivity and specificity. GCS = global circumferential strain.
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