Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis

Magne, Julien; Cosyns, Bernard; Popescu, Bogdan Alexandru; Carstensen, Helle Gervig; Dahl, Jordi Sanchez; Desai, Milind Y.; Kearney, Leighton; Lancellotti, Patrizio; Marwick, Thomas H.; Sato, Kimi; Takeuchi, Masaaki; Zito, Concetta; Casalta, Anne-Claire; Mohty, Dania; Pierard, Luc; Habib, Gilbert; Donal, Erwan; LTSI, Inserm

doi:10.1016/j.jcmg.2018.11.005

Article (Scientific journals)

Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis

Magne, Julien; Cosyns, Bernard; Popescu, Bogdan Alexandru et al.

2019 • In JACC. Cardiovascular Imaging, 12 (1), p. 84-92

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/245620

DOI
10.1016/j.jcmg.2018.11.005

PubMed
30621997

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Abstract :

[en] Objectives: In this individual participant data meta-analysis on left ventricular global longitudinal strain (LVGLS), our objective was to: 1) describe its distribution; 2) identify the most predictive cutoff values; and 3) assess its impact on mortality in asymptomatic patients with significant aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF). Background: The evidence supporting the prognostic role of LVGLS in asymptomatic patients with AS has been obtained from several relatively small studies. Methods: A literature search was performed for studies published between 2005 and 2017 without language restriction according to the following criteria: “aortic stenosis” AND “longitudinal strain.” The corresponding authors of selected studies were contacted and invited to share their data that we computerized in a specific database. The primary endpoint was all-cause mortality. Results: Among the 10 studies included, 1,067 asymptomatic patients with significant AS and LVEF >50% were analyzed. The median of LVGLS was 16.2% (from 5.6% to 30.1%). There were 91 deaths reported during follow-up with median of 1.8 (0.9 to 2.8) years, resulting in a pooled crude mortality rate of 8.5%. The LVGLS performed well in the prediction of death (area under the curve: 0.68). The best cutoff value identified was LVGLS of 14.7% (sensitivity, 60%; specificity, 70%). Using random effects model, the risk of death for patients with LVGLS <14.7% is multiplied by >2.5 (hazard ratio: 2.62; 95% confidence interval: 1.66 to 4.13; p < 0.0001), without significant heterogeneity between studies (I2 = 18.3%; p = 0.275). The relationship between LVGLS and mortality remained significant in patients with LVEF ≥60% (p = 0.001). Conclusions: This individual participant data meta-analysis demonstrates that in asymptomatic patients with significant AS and normal LVEF, impaired LVGLS is associated with reduced survival. These data emphasize the potential usefulness of LVGLS for risk stratification and management of these patients. © 2018 American College of Cardiology Foundation

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

Magne, Julien; CHU Limoges, Hôpital Dupuytren, Service Cardiologie, INSERM 1094, Limoges, France

Cosyns, Bernard; UZ Brussel-CVHZ, Brussels, Belgium

Popescu, Bogdan Alexandru; University of Medicine and Pharmacy “Carol Davila”—Euroecolab, Institute of Cardiovascular Diseases “Prof. Dr. C. C. Iliescu,”, Bucharest, Romania

Carstensen, Helle Gervig; Department of Cardiology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

Dahl, Jordi Sanchez; Department of Cardiology, Odense University Hospital, Odense, Denmark

Desai, Milind Y.; Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States

Kearney, Leighton; Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia

Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation

Marwick, Thomas H.; Baker Heart and Diabetes Institute, Melbourne, Australia

Sato, Kimi; Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

More authors (8 more)

Language :

English

Title :

Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis

Publication date :

2019

Journal title :

JACC. Cardiovascular Imaging

ISSN :

1936-878X

eISSN :

1876-7591

Publisher :

Elsevier Inc.

Volume :

Issue :

Pages :

84-92

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 05 March 2020

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