Clinical Outcomes and Prognosis

1326127 - Association of Global Longitudinal Strain (GLS) by Feature Tracking MRI with Cardiovascular Outcomes. The Dallas Heart Study.

Thursday, January 26, 2023

1:00 PM – 2:00 PM

Location: Pacific Jewel

Presenting Author(s)

VS

Vinayak Subramanian, MD

Research Fellow
The University of Texas Southwestern Medical Center, United States

Primary Author(s)

VS

Vinayak Subramanian, MD

Research Fellow
The University of Texas Southwestern Medical Center, United States

Co-Author(s)

NK

Nitin Kondamudi, MD

Fellow Physician
The University of Texas Southwestern Medical Center, United States
AC

Alvin Chandra, MD

Assistant Professor
The University of Texas Southwestern Medical Center, United States
JB

Jarett Berry, MD

Professor
The University of Texas Southwestern Medical Center, United States
AP

Ambarish Pandey, MD

Assistant Professor
The University of Texas Southwestern Medical Center, United States

Background: We aim to evaluate the association of Global Longitudinal Strain (GLS) by feature tracking cardiac MRI with cardiovascular outcomes in healthy individuals free of cardiovascular disease using the Dallas Heart Study (DHS).

Methods: We included all participants who completed all three visits part of DHS with Cardiac MR of sufficient quality for strain analysis. GLS was computed using Feature Tracking Cardiac MRI (FT-CMR). The primary outcome was a composite of Major Adverse Cardiovascular events (MACE) which included – Myocardial infarction, incident heart failure (HF), hospitalization for atrial fibrillation, coronary revascularization, and all-cause-death. Secondary Outcomes included a composite of recurrent HF and death, and all-cause death. The cohort was stratified by quartiles of GLS (Q1-Q4). Cox Proportional Hazards models were constructed to evaluate the association between quartiles of GLS and the primary and secondary outcome using Q1 as the referent group.

Results: The present study included 2803 participants. The primary composite outcome of MACE occurred in 11.5% of participants. The incidence of the composite endpoint increased incrementally across each GLS quartile, such that participants in the highest quartile of GLS (greatest impairment in GLS) had the highest risk MACE. Incidence of MACE was 1487 per 10,000 person-years in Q4 compared to 615 per 10,000 person-years in Q1. A similar pattern was observed in adjusted analysis. Across increasing quartiles of impaired GLS, participants had incrementally higher of risk of MACE (Table 1) after adjustment for CVD risk factors, cardiac biomarkers, and left ventricular ejection fraction. This pattern of association was observed for the secondary outcomes of recurrent HF and death, and all-cause mortality.

Conclusion: Impaired GLS by FT-CMR is associated with adverse cardiovascular events in a community cohort without prevalent cardiovascular disease, independent of CVD risk factors, cardiac biomarkers, LV systolic function measured by EF.