Potential Prognostic Relevance of Left-Ventricular Global Longitudinal Strain and of the Summation of the Mitral and Tricuspid Regurgitation Volume in Patients with Non-Ischemic Dilated Cardiomyopathy

• Published in: Journal of cardiovascular development and disease Vol. 10; no. 10; p. 410
• Main Authors: Mėlinytė-Ankudavičė, Karolina, Ereminienė, Eglė, Mizarienė, Vaida, Šakalytė, Gintarė, Plisienė, Jurgita, Jurkevičius, Renaldas
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.09.2023; MDPI
• Subjects: 2D echocardiography; Cardiac arrhythmia; Cardiology; Cardiomyopathy; Cardiomyopathy, Dilated; Care and treatment; Disease; early primary outcomes; Genetic testing; Heart; heart failure; Hemodynamics; Hospitals; Ischemia; Medical prognosis; Medical research; Medicine, Experimental; Mortality; non-ischemic dilated cardiomyopathy; Patients; 2D echocardiography; heart failure; non-ischemic dilated cardiomyopathy; early primary outcomes
• ISSN: 2308-3425; 2308-3425
• DOI: 10.3390/jcdd10100410

The aim of this pilot study was to determine the potential prognostic relevance of novel multidirectional myocardial and volumetric echocardiographic parameters in patients with non-ischemic dilated cardiomyopathy (NIDCM). Multidirectional myocardial parameters (longitudinal, radial, and circumferential left-ventricular (LV) strain using speckle tracking echocardiography) and a new volumetric parameter (the sum of the mitral and tricuspid regurgitation volume (mitral-tricuspid regurgitation volume) were assessed. The cardiovascular (CV) outcome was a composite of cardiac death and hospitalization for heart failure (HF) at 1 year. Approximately 102 patients were included in this pilot study. The mean LV ejection fraction (LVEF) was 28.4 ± 8.9%. During a follow-up of 1 year, the CV outcome occurred in 39 patients (10 HF deaths, and 36 hospitalizations for HF). The LV global longitudinal systolic strain (GLS) and mitral-tricuspid regurgitation volume were the main parameters that were seen to be significantly altered in the comparison of patients with events vs. those without events (GLS (absolute values) 7.4 ± 2.7% vs. 10.3 ± 2.6%; mitral-tricuspid regurgitation volume 61.1 ± 20.4 mL vs. 40.9 ± 22.9 mL, respectively; -value < 0.01). In line with these findings, in a multivariate continuous logistic regression analysis, the GLS and mitral-tricuspid regurgitation volume were the main parameters associated with worse CV outcomes (GLS: OR 0.77 (95%CI 0.65-0.92); mitral-tricuspid regurgitation volume OR 1.09 (95%CI 1.01-1.25)), whereas the radial and circumferential LV global strain and mitral regurgitation volume and tricuspid regurgitation volume were not linked to the CV outcome. Furthermore, in a receiver operating characteristic curve analysis, a GLS cutoff of <7.5% and mitral-tricuspid regurgitation volume > 60 mL were the identified values for the parameters associated with worse CV outcomes. The findings of this pilot study suggest that the GLS and a novel volumetric parameter (the sum of the mitral and tricuspid regurgitation volume) are linked to worse CV outcomes in patients with non-ischemic dilated cardiomyopathy. Hence, these promising results warrant further validation in larger studies.