Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy.
<h4>Introduction</h4>Chronic Chagas cardiomyopathy (CCC) is associated with a high incidence of cardiovascular events. Global longitudinal strain (GLS) is useful in predicting adverse cardiovascular outcomes in several cardiomyopathies. However, its prognostic value in CCC is not well es...
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Public Library of Science (PLoS)
2025-08-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0012941 |
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| author | Minna Moreira Dias Romano Henrique Turin Moreira Fawaz Alenezi Joseph Kisslo Bernardo Lombo Lievano André Schmidt Benedito Carlos Maciel José Antônio Marin-Neto Eric J Velazquez |
| author_facet | Minna Moreira Dias Romano Henrique Turin Moreira Fawaz Alenezi Joseph Kisslo Bernardo Lombo Lievano André Schmidt Benedito Carlos Maciel José Antônio Marin-Neto Eric J Velazquez |
| author_sort | Minna Moreira Dias Romano |
| collection | DOAJ |
| description | <h4>Introduction</h4>Chronic Chagas cardiomyopathy (CCC) is associated with a high incidence of cardiovascular events. Global longitudinal strain (GLS) is useful in predicting adverse cardiovascular outcomes in several cardiomyopathies. However, its prognostic value in CCC is not well established.<h4>Methods</h4>This study was a retrospective echocardiography analysis with prospective follow-up of CCC subjects. GLS was defined as the average of three apical peak longitudinal strain measurements of the LV using vendor-independent software. GLS groups were defined according to tertiles: (1) GLS ≤ -18.4%, (2) GLS > -18.4% and <-13.8%, and (3) GLS ≥ -13.8%. The primary outcome was a composite of death, hospitalization, sustained ventricular tachycardia (SVT), new heart failure, any systemic embolism, hospitalization, reverted cardiac arrest and cardiac heart transplantation.<h4>Results</h4>GLS was obtained in 77 subjects, 50.6% were males and the mean age was 56 ± 15 years. There were 6.49% losses of follow-up and the mean LVEF was 51 ± 14%. After a follow-up period of 35 ± 19 months (2.9 y), 33 subjects reached the composite outcome. Death and hospitalization were the most frequent outcomes (n = 9), followed by new heart failure (n = 6), embolism (n = 6), and SVT (n = 3). The GLS ≥ -13.8% was associated with a worse prognosis when compared with the other tertile GLS groups (log rank-p-value = 0.001 for both comparisons). On the multivariate Cox proportional hazard model, adjusting for age, gender, and LVEF, GLS was an independent predictor of outcomes with an HR of 1.20 (CI = 1.05-1.38;p = 0.008).<h4>Conclusion</h4>Left ventricle GLS is an independent predictor of cardiovascular outcomes in patients with CCC. GLS may be an important tool for Chagas disease risk stratification, independent of LVEF. |
| format | Article |
| id | doaj-art-e6f1a0b5e6fc4e198d5f936cb2b90d13 |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2025-08-01 |
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| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-e6f1a0b5e6fc4e198d5f936cb2b90d132025-08-23T05:33:10ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-08-01198e001294110.1371/journal.pntd.0012941Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy.Minna Moreira Dias RomanoHenrique Turin MoreiraFawaz AleneziJoseph KissloBernardo Lombo LievanoAndré SchmidtBenedito Carlos MacielJosé Antônio Marin-NetoEric J Velazquez<h4>Introduction</h4>Chronic Chagas cardiomyopathy (CCC) is associated with a high incidence of cardiovascular events. Global longitudinal strain (GLS) is useful in predicting adverse cardiovascular outcomes in several cardiomyopathies. However, its prognostic value in CCC is not well established.<h4>Methods</h4>This study was a retrospective echocardiography analysis with prospective follow-up of CCC subjects. GLS was defined as the average of three apical peak longitudinal strain measurements of the LV using vendor-independent software. GLS groups were defined according to tertiles: (1) GLS ≤ -18.4%, (2) GLS > -18.4% and <-13.8%, and (3) GLS ≥ -13.8%. The primary outcome was a composite of death, hospitalization, sustained ventricular tachycardia (SVT), new heart failure, any systemic embolism, hospitalization, reverted cardiac arrest and cardiac heart transplantation.<h4>Results</h4>GLS was obtained in 77 subjects, 50.6% were males and the mean age was 56 ± 15 years. There were 6.49% losses of follow-up and the mean LVEF was 51 ± 14%. After a follow-up period of 35 ± 19 months (2.9 y), 33 subjects reached the composite outcome. Death and hospitalization were the most frequent outcomes (n = 9), followed by new heart failure (n = 6), embolism (n = 6), and SVT (n = 3). The GLS ≥ -13.8% was associated with a worse prognosis when compared with the other tertile GLS groups (log rank-p-value = 0.001 for both comparisons). On the multivariate Cox proportional hazard model, adjusting for age, gender, and LVEF, GLS was an independent predictor of outcomes with an HR of 1.20 (CI = 1.05-1.38;p = 0.008).<h4>Conclusion</h4>Left ventricle GLS is an independent predictor of cardiovascular outcomes in patients with CCC. GLS may be an important tool for Chagas disease risk stratification, independent of LVEF.https://doi.org/10.1371/journal.pntd.0012941 |
| spellingShingle | Minna Moreira Dias Romano Henrique Turin Moreira Fawaz Alenezi Joseph Kisslo Bernardo Lombo Lievano André Schmidt Benedito Carlos Maciel José Antônio Marin-Neto Eric J Velazquez Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy. PLoS Neglected Tropical Diseases |
| title | Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy. |
| title_full | Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy. |
| title_fullStr | Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy. |
| title_full_unstemmed | Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy. |
| title_short | Global longitudinal strain as a predictor of outcomes in chronic Chagas´ cardiomyopathy. |
| title_sort | global longitudinal strain as a predictor of outcomes in chronic chagas´ cardiomyopathy |
| url | https://doi.org/10.1371/journal.pntd.0012941 |
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