Abstract 4363406: Impact of Global Longitudinal Strain on Event-Free Survival Time of Patients with Heart Failure

Abstract

Introduction: Left ventricular global longitudinal strain (GLS) is a known independent predictor of mortality and hospitalization in heart failure (HF). Nonetheless, the impact of GLS on the event-free survival time remains unclear. Hypothesis: We hypothesize an improvement of GLS is associated with an increase in the event-free survival of patients with HF. Method: A single center, retrospective, cohort, observational study was conducted among consecutive patients with HF from all spectra of ejection fraction, with at least two echocardiograms: one on admission and another one at follow-up encounter. Subjects were identified from the pool of echocardiograms performed between October 2023 and April 2024 in the New York Metropolitan Hospital. Cases with atrial fibrillation, hemodialysis and poor echocardiogram images were excluded. Electronic medical records were reviewed from October 2023 to March 2025; The GLS from the penultimate (GLS1) and latest echocardiogram (GLS2) were assessed by 2-dimensional speckle-tracking software and were converted to absolute GLS for presentation purposes. Patients were divided according to the median GLS2 into two groups: above and below 11.35. Primary outcome was time to first occurrence of HF hospitalization or cardiovascular death. Results: Out of 325 subjects, 63 met inclusion criteria for the final analysis. Mean follow-up interval was 415 ± 41 days. Mean interval between echocardiograms was 374 ± 34 days. Median GLS of the penultimate and last echocardiogram were 12.00 and 11.35, respectively. Patients with higher GLS2 correlated with longer event-free survival time, 95% CI (0.13 – 0.60), df=62; p=0.039. When analyzing continuous variables (df=62), every 1 unit increment of GLS, the event-free survival time increased by 12 ±2.2 days, CI=95%; p=0.037. Those with GLS2≧11.35 showed longer event-free survival according to the Kaplan Meier Curve: Chi Sq (Breslow, and Tarone-Ware methods) = 8.470 (df=1); 95 % CI; p=0.005. Conclusion: Improvement of GLS is associated with an increase in the event-free survival of patients with HF. For every 1-unit increment of GLS, the event-free survival time will increase by 12 days.