Background

Impaired left ventricular (LV) longitudinal function (LF) is a known predictor of cardiac events in patients with heart failure, but two-dimensional strain imaging, the reference method to measure myocardial deformation, is not always feasible or available. Therefore, reliable and reproducible alternatives are needed. The aim of the present study was to evaluate unidimensional longitudinal strain (ULS) as a simple echocardiographic parameter for the assessment of LV LF.

Methods

Two hundred two patients with dilated cardiomyopathy who had their first presentation in the authors' cardiology department, as well as the same number of age- and gender-matched control subjects, were prospectively included in this study. ULS was compared with global longitudinal strain (GLS), the current gold standard for LV LF assessment by echocardiography. Uni- and multivariate Cox regression analyses were conducted to evaluate the prognostic value of ULS.

Results

LV LF was higher in the control group compared with patients: GLS −19.5 ± 1.7% versus −12.6 ± 4.8% and ULS −16.3 ± 1.5% versus −10.2 ± 3.9% (P < .001 for each). Correlation between ULS and GLS was excellent (r = 0.94), while Bland-Altman plots revealed lower values for ULS (bias −2.76%, limits of agreement ±3.31%). During a mean follow-up time of 39 months, the combined end point of cardiovascular death or hospitalization for acute cardiac decompensation was reached by 28 patients (13.9%). GLS (hazard ratio, 1.21; 95% CI, 1.10–1.34; P < .001) and ULS (hazard ratio, 1.24; 95% CI, 1.12–1.39; P < .001) had comparable prognostic impact on patient outcomes.

Conclusions

ULS might be an alternative echocardiographic method for the assessment of LV LF, with similar diagnostic and prognostic value compared with GLS.

中文翻译：

---

一维纵向应变：通过超声心动图评估纵向心肌变形的一种简单方法

背景

左心室（LV）纵向功能受损（LF）是心力衰竭患者心脏事件的已知预测指标，但是二维应变成像（测量心肌变形的参考方法）并不总是可行或可用的。因此，需要可靠且可重现的替代方案。本研究的目的是评估一维纵向应变（ULS）作为评估LV LF的简单超声心动图参数。

方法

前瞻性地纳入了在作者的心脏病科首次就诊的22例扩张型心肌病患者，以及相同数量的年龄和性别匹配的对照组。将ULS与整体纵向应变（GLS）进行了比较，GLS是当前通过超声心动图评估LV LF的金标准。进行单因素和多因素Cox回归分析以评估ULS的预后价值。

结果

与患者相比，对照组的LV LF更高：GLS -19.5±1.7％对-12.6±4.8％和ULS -16.3±1.5％对-10.2±3.9％（ 每个P <.001）。ULS和GLS之间的相关性极好（r  = 0.94），而Bland-Altman图显示ULS的值较低（偏差-2.76％，一致性限制为±3.31％）。在平均39个月的随访期间，有28位患者（13.9％）达到了心血管死亡或因急性心脏代偿失调而住院的合并终点。GLS（危险比，1.21； 95％CI，1.10–1.34；P  <.001）和ULS（危险比，1.24； 95％CI，1.12-1.39；P  <.001）对患者预后具有可比性。

结论

ULS可能是评估LV LF的另一种超声心动图方法，与GLS相比具有相似的诊断和预后价值。